Organization
OKLAHOMA WEST PHYSICIANS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA R STUTZMAN DO (PHYSICIAN)
(405) 663-2291
Entity
Organization
Contact information
Practice address
579 N BROADWAY AVE, HYDRO, OK 73048-8425
(405) 663-2291
(405) 663-2121
Mailing address
579 N BROADWAY AVE, HYDRO, OK 73048-8425
(405) 663-2291
(405) 663-2121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3099
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
446748104001
BLUE CROSS/BLUE SHIELD
OK
Enumeration date
11/05/2007
Last updated
11/05/2007
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