# MIDWEST MEDICAL GROUP PLLC

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

## Provider details

- **NPI number:** 1508842444
- **Authorized official:** DEBBIE ANDERSON (OFFICE MANAGER)
- **Authorized official phone:** (405) 739-6840

## Contact information

- **Practice address:** 1201 S DOUGLAS BLVD, SUITE J, MIDWEST CITY, OK 73130-5239
- **Practice address phone:** (405) 739-6840
- **Practice address fax:** (405) 732-7149
- **Mailing address:** 1201 S DOUGLAS BLVD, SUITE J, MIDWEST CITY, OK 73130-5239
- **Mailing address phone:** (405) 739-6840
- **Mailing address fax:** (405) 732-7149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/22/2005
- **Last updated:** 12/11/2014