MEDICARE: THE DEWEBER GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1134658024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DEWEBER GROUP, LLC

Provider Business Mailing Address
First Line	:	8800 S PENNSYLVANIA AVE STE 101
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-5211
Country	:	US
Telephone Number	:	405-305-8762
Fax Number	:

Provider Business Practice Location Address
First Line	:	8800 S PENNSYLVANIA AVE STE 101
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-5211
Country	:	US
Telephone Number	:	405-305-8762
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	DR. DERICK D DEWEBER
Credential	:	PHD, CCC-SLP
Telephone Number	:	405-305-8762

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	07/21/2022

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Directions to “THE DEWEBER GROUP, LLC ” Practice Location

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