# SOUTH WELLNESS COMMUNITY HEALTH CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA-OU PHYSICIANS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1235546961
- **Legal business name:** BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA-OU PHYSICIANS
- **Authorized official:** BRIAN L MADDY (CEO)
- **Authorized official phone:** (405) 271-3932

## Contact information

- **Practice address:** 1122 NE 13TH ST, ORI 274, OKLAHOMA CITY, OK 73117-1039
- **Practice address phone:** (405) 271-5860
- **Practice address fax:** (405) 778-6843
- **Mailing address:** 2149 SW 59TH ST, OKLAHOMA CITY, OK 73119-7033
- **Mailing address phone:** (405) 271-5860
- **Mailing address fax:** (405) 778-6843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/15/2014
- **Last updated:** 05/18/2015