# DEACONESS FAMILY CARE WEST HEFNER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Deaconess Family Care West Hefner
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811006455
- **Authorized official:** WADDAH N. NASSAR MD (OWNER)
- **Authorized official phone:** (405) 470-6900

## Contact information

- **Practice address:** 7221 W HEFNER RD, OKLAHOMA CITY, OK 73162-4505
- **Practice address phone:** (405) 470-6900
- **Practice address fax:** (405) 470-6900
- **Mailing address:** 7221 W HEFNER RD, OKLAHOMA CITY, OK 73162-4505
- **Mailing address phone:** (405) 470-6900
- **Mailing address fax:** (405) 470-6900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 03/07/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 20-0276256-001 | BC/BC GROUP \# | OK |
| 05 | — | 200017560A | — | OK |