Organization
WATERVIEW MEDICAL CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG L TERRELL (SR VP, COO)
(405) 307-1000
Entity
Organization
Contact information
Practice address
2625 SW 119TH ST, SUITE A, OKLAHOMA CITY, OK 73170-2654
(405) 692-4777
(405) 692-4778
Mailing address
PO BOX 1330, NORMAN, OK 73070-1330
(405) 692-4777
(405) 692-4778
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700690N
—
OK
Enumeration date
05/08/2006
Last updated
08/31/2012
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