Woundynamics LLC

Organization Active NPI Family Medicine Physician · Oklahoma City, OK

NPI 1114535333 · NPPES record last updated Oct 10, 2023

Key facts

NPI
1114535333
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
WOUNDYNAMICS LLC
Practice address
1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357
Phone
(206) 465-4313
NPI assigned
Jul 14, 2020
Organization subpart
No

Authorized official

Name
Danh Pham, DO NPI 1932426269
Title
DO
Phone
(405) 225-1122

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 11

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200728000660 OK Part B Supplier - Clinic/Group Practice 7719301449 Receives reassigned benefits from 11 practitioners
Practice locations: Oklahoma City, OK
O20220427002886 OK DME Supplier - Physician - General Practice 7719301449 Practice locations: Oklahoma City, OK

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357

Mailing address

1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357
Phone (206) 465-4313

Other providers in Oklahoma City, OK

All providers in Oklahoma City, OK · Family Medicine Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.