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Organization
DEACONESS FAMILY CARE WEST HEFNER
Active
Organization
DEACONESS FAMILY CARE WEST HEFNER
Active
Other names
Deaconess Family Care West Hefner
Organization subpart
No
Provider details
NPI number
Authorized official
WADDAH N. NASSAR MD (OWNER)
(405) 470-6900
Entity
Organization
Contact information
Practice address
7221 W HEFNER RD, OKLAHOMA CITY, OK 73162-4505
(405) 470-6900
(405) 470-6900
Mailing address
7221 W HEFNER RD, OKLAHOMA CITY, OK 73162-4505
(405) 470-6900
(405) 470-6900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-0276256-001
BC/BC GROUP #
OK
05
—
200017560A
—
OK
Enumeration date
08/29/2006
Last updated
03/07/2012
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