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Organization
BAPTIST HEALTHCARE OF OKLAHOMA
Active
Organization
BAPTIST HEALTHCARE OF OKLAHOMA
Active
Other names
INTEGRIS Mayes County Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS KENT WEAVER (PRESIDENT)
(918) 825-1600
Entity
Organization
Contact information
Practice address
1301 NE 1ST ST, PRYOR, OK 74361-8850
(918) 824-7777
(918) 824-6414
Mailing address
1301 NE 1ST ST, PRYOR, OK 74361-8850
(918) 824-7777
(918) 824-6414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200039950A
—
OK
01
—
37D1030240
CLIA
OK
Enumeration date
04/20/2006
Last updated
03/31/2011
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