Organization
GWEN FUENTES MD PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GWEN CANARIAS FUENTES M.D. (OWNER)
(580) 223-5693
Entity
Organization
Contact information
Practice address
919 15TH AVE NW, ARDMORE, OK 73401-1809
(580) 223-5693
(580) 223-8909
Mailing address
919 15TH AVE NW, ARDMORE, OK 73401-1809
(580) 223-5693
(580) 223-8909
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
13171
OK
261QM2500X
Medical Specialty Clinic/Center
Primary
13171
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100209330A
—
OK
05
—
100209330C
—
OK
Enumeration date
04/18/2007
Last updated
01/30/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us