Organization
MEDICINE WHEEL INC
Active
Other names
Caddo Family Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL E WEATHERS DO (MEDICAL DIRECTOR)
(580) 367-2100
Entity
Organization
Contact information
Practice address
128 BUFFALO STREET, CADDO, OK 74729
(580) 367-2100
(580) 367-2103
Mailing address
PO BOX 146, CADDO, OK 74729-0146
(580) 367-2100
(580) 367-2103
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
2982
OK
207Q00000X
Family Medicine Physician
Primary
2982
OK
Other
Enumeration date
11/16/2012
Last updated
11/16/2012
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