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General NPI Number Information
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NPI Number | 1801313564
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Entity Type | Organization
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Legal Business Name | DISCOVER WELL-BEINGS, PLLC
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | CROSSROADS WELLNESS CENTER 1107 E CARLTON LN
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City | KANSAS
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State | OK
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Zip | 74347
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Country | US
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Telephone | 918-964-6425
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Fax | 918-289-2519
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Provider Business Mailing Address
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Address Line | 52390 E 333 RD
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City | JAY
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State | OK
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Zip | 74346-5198
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Country | US
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Telephone | 918-919-2272
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Fax | 918-786-2402
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Authorized Official
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Title or Position | PHYSICIAN CO-OWNER
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Name | DR. MARCIA KAY MATTHEWS
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Credential | MD
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Telephone | 918-919-2272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 19451
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License Number State | OK
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