Organization
FOOT AND ANKLE CLINIC OF WESTERN OKLAHOMA, PLLC
Active
Other names
Foot & Ankle Clinic of Western Oklahoma
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY DEWAYNE NELSON DPM (OWNER)
(580) 323-5800
Entity
Organization
Contact information
Practice address
900 N MAIN ST, ELK CITY, OK 73644-9998
(580) 225-9955
(580) 225-9954
Mailing address
207 S 30TH STREET, CLINTON, OK 73601
(580) 323-5800
(580) 323-5802
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
230
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200026900A
—
OK
05
—
200026910A
—
OK
01
—
200522085
MEDICARE GROUP
OK
01
—
P00162625
RAILROAD MEDICARE
OK
Enumeration date
05/08/2008
Last updated
08/28/2025
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