Organization
HEFNER WEST MEDICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LABID SAM MUSALLAM M.D. (PHYSICIAN)
(405) 942-0090
Entity
Organization
Contact information
Practice address
4400 NW 63RD ST, OKLAHOMA CITY, OK 73116-1545
(405) 942-0090
(405) 942-8055
Mailing address
4400 NW 63RD ST, OKLAHOMA CITY, OK 73116-1545
(405) 942-0090
(405) 942-8055
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
11815
OK
Other
Enumeration date
06/11/2006
Last updated
04/20/2008
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