Organization
OB-GYN CARE OF NORTHWEST OKLAHOMA
Active
Other names
A CARING PLACE FOR WOMEN
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN MARVIN WAGNER M.D. (SOLE PROPRIETOR)
(580) 256-6000
Entity
Organization
Contact information
Practice address
1024 MAIN ST, WOODWARD, OK 73801-3120
(580) 256-6000
(580) 256-6008
Mailing address
1024 MAIN ST, WOODWARD, OK 73801-3120
(580) 256-6000
(580) 256-6008
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24684
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200073250A
—
OK
01
—
278469022001
BLUE CROSS
OK
Enumeration date
07/26/2006
Last updated
07/03/2008
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