# W MEDICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** W Medical Services LLC, W Aesthetics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912717711
- **Authorized official:** IVAN WAYNE MD (OWNER/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (405) 748-5950

## Contact information

- **Practice address:** 10001 BROADWAY EXT STE A, OKLAHOMA CITY, OK 73114-6307
- **Practice address phone:** (405) 748-5950
- **Practice address fax:** (405) 607-3580
- **Mailing address:** 6608 N WESTERN AVE \# 416, NICHOLS HILLS, OK 73116-7326
- **Mailing address phone:** (405) 748-5950
- **Mailing address fax:** (405) 607-3580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/13/2025
- **Last updated:** 01/13/2025