Derek Ethan Webber

Individual provider Active NPI Case Manager/Care Coordinator · Midwest City, OK

NPI 1093084352 · NPPES record last updated Dec 15, 2011

Key facts

NPI
1093084352
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
316 S Midwest Blvd
Midwest City, OK 73110-4642
Phone
(405) 733-5437
Fax
(405) 732-7741
NPI assigned
Dec 15, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-del Youth & Family Center, Inc. Past Accepting new patients
Mid-del Youth and Family Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

316 S Midwest Blvd
Midwest City, OK 73110-4642

Mailing address

316 S Midwest Blvd
Midwest City, OK 73110-4642
Phone (405) 733-5437

Other providers in Midwest City, OK

All providers in Midwest City, OK · Case Manager/Care Coordinator in Oklahoma

Sources for this page

Verify at the official NPI Registry.