Connie M Wilson DO PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

3394 Issued in OK

Legal business name

CONNIE M WILSON DO PC

Practice address

1005 15TH Ave NW
Ardmore, OK 73401-1810

Phone

(580) 226-1010

Fax

(580) 226-1011

NPI assigned

Jun 14, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Connie M Wilson, DO

Title

Owner / President

Phone

(580) 504-5596

Specialties & licenses 1

Addresses

Other names 1

• Wilson Loughridge Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frelyn G Loughridge, APRN-CNP

  • Family Nurse Practitioner
  • Ardmore, OK
  • NPI 1932165768
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1043505456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1987",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734021987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 15TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011810",
            "telephone_number": "580-226-1010",
            "fax_number": "580-226-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNIE M WILSON DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "580-504-5596",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "3394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson Loughridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronald James Collins, RADT
• Tonya R Collins
• Bobbie Collinsworth
• Ryllie Collinsworth
• Community Youth Services of Southern Oklahoma, Inc.
• Tars'Jah Cook, RBT
• Autumn Michelle Cooper, MBS, LPC
• Franklin D Cooper II, DPM
• Robin Cooper, CCC-SLP
• Scott Allen Cooper, PA-C

• Internal Medicine Physician in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.