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General NPI Number Information
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NPI Number | 1831122878
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Entity Type | Organization
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Legal Business Name | DNW, PC, INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 1650 S MAIN ST
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City | MCALESTER
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State | OK
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Zip | 74501-7094
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Country | US
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Telephone | 918-429-1800
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Fax | 918-429-1804
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Provider Business Mailing Address
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Address Line | 1650 S MAIN ST
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City | MCALESTER
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State | OK
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Zip | 74501-7094
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Country | US
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Telephone | 918-429-1800
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Fax | 918-429-1804
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NANCE D WEDDLE
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Credential | D.O.
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Telephone | 918-429-1800
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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 | 3975
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License Number State | OK
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