# MEDWISE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDWISE LLC
- **Other names:** MedWise LLC - Sand Springs
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1447064175
- **Legal business name:** MEDWISE LLC
- **Authorized official:** DENNIS SIDNEY BLACKSTAD MD (PRESIDENT)
- **Authorized official phone:** (918) 605-6582

## Contact information

- **Practice address:** 110 E 41ST ST, SAND SPRINGS, OK 74063-3851
- **Practice address phone:** (918) 727-2831
- **Mailing address:** 12902 E 51ST ST, TULSA, OK 74134-6712
- **Mailing address phone:** (918) 994-3476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/04/2025
- **Last updated:** 02/04/2025