# WESTERN MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164737243
- **Authorized official:** DR. CECIL A MOORE D.O. (PHYSICIAN)
- **Authorized official phone:** (405) 708-4686

## Contact information

- **Practice address:** 7300 S WESTERN AVE, OKLAHOMA CITY, OK 73139-2002
- **Practice address phone:** (405) 708-4686
- **Practice address fax:** (866) 313-9161
- **Mailing address:** PO BOX 892518, OKLAHOMA CITY, OK 73189-2518
- **Mailing address phone:** (405) 708-4686
- **Mailing address fax:** (866) 313-9161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 3777 | OK | Yes |

## Other

- **Enumeration date:** 08/12/2010
- **Last updated:** 08/12/2010