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Organization

NEPHROLOGY AND HYPERTENSION CLINIC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
S W MCENTIRE (OFFICE MANAGER)
(405) 737-0881
Entity
Organization

Contact information

Practice address
1380 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5215
(405) 737-0881
(405) 737-0899
Mailing address
1380 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5215
(405) 737-0881
(405) 737-0899

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
731570351-001
BCBS DR N ID
OK
Enumeration date
05/08/2007
Last updated
08/22/2020
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