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General NPI Number Information
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NPI Number | 1932366879
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Entity Type | Organization
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Legal Business Name | DR. KIERSTEN B. WEBER
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 1205 HEALTH CENTER PKWY
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City | YUKON
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State | OK
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Zip | 73099-6396
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Country | US
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Telephone | 405-717-7955
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Fax | 405-717-7958
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Provider Business Mailing Address
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Address Line | 600 W 15TH ST
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City | EDMOND
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State | OK
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Zip | 73013-3617
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Country | US
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Telephone | 405-340-9251
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Fax | 405-340-0686
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Authorized Official
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Title or Position | DR. OF PODIATRY
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Name | DR. KIERSTEN B. WEBER
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Credential | DPM
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Telephone | 405-340-9251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 212
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License Number State | OK
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