Organization
HEART AND VASCULAR CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD GLEN WOODSON (ADMINISTRATOR)
(580) 250-4278
Entity
Organization
Contact information
Practice address
3106 NW ARLINGTON AVE, LAWTON, OK 73505-6123
(580) 250-4278
(580) 581-1548
Mailing address
3106 NW ARLINGTON AVE, LAWTON, OK 73505-6123
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200069590A
—
OK
Enumeration date
12/05/2011
Last updated
12/05/2011
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