Organization
BAPTIST HEALTHCARE OF OKLAHOMA
Active
Other names
INTEGRIS Mayes County Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS KENT WEAVER (PRESIDENT)
(918) 825-1600
Entity
Organization
Contact information
Practice address
1301 NE 1ST ST, PRYOR, OK 74361-8850
(918) 824-7777
(918) 824-6414
Mailing address
1301 NE 1ST ST, PRYOR, OK 74361-8850
(918) 824-7777
(918) 824-6414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200039950A
—
OK
01
—
37D1030240
CLIA
OK
Enumeration date
04/20/2006
Last updated
03/31/2011
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