Organization
W PROFESSIONAL SURGICAL SERVICES PLLC
Active
Organization
W PROFESSIONAL SURGICAL SERVICES PLLC
Active
Other names
W Aesthetics
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN WAYNE MD (PHYSICIAN & OWNER)
(405) 748-5950
Entity
Organization
Contact information
Practice address
10001 BROADWAY EXT STE A, OKLAHOMA CITY, OK 73114-6307
(405) 748-5950
(405) 607-3580
Mailing address
6608 N WESTERN AVE # 416, NICHOLS HILLS, OK 73116-7326
(405) 748-5950
(405) 607-3580
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
—
Other
Enumeration date
01/29/2025
Last updated
01/30/2025
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