Organization
D E WADSWORTH JR OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARWIN E WADSWORTH JR. OD (OWNER)
(405) 543-1846
Entity
Organization
Contact information
Practice address
1936 N PERKINS RD, STILLWATER, OK 74075-2978
(405) 543-1846
Mailing address
1936 N PERKINS RD, STILLWATER, OK 74075-2978
(405) 543-1846
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100765550B
—
OK
Enumeration date
01/15/2021
Last updated
03/17/2021
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