Individual
DR. MONICA WARDWELL FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 CHILDRENS AVE STE 14000, OKLAHOMA CITY, OK 73104-4637
(405) 271-4417
Mailing address
1601 SIMON AVE, EDMOND, OK 73003-3743
(409) 791-8863
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R8738
TX
208M00000X
Hospitalist Physician
R8738
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2014
Last updated
03/28/2019
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