Organization
WESTEREN GASTROINTESEINAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUGH M LEAVENS MD (OWNER)
(580) 210-0040
Entity
Organization
Contact information
Practice address
1800 W 3RD ST, ELK CITY, OK 73644-5146
(580) 210-0040
(405) 330-9082
Mailing address
PO BOX 189, ELK CITY, OK 73648-0189
(580) 210-0040
(405) 330-9082
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
27215
OK
Other
Enumeration date
02/21/2012
Last updated
06/13/2012
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