Pawnee Health & Wellness Clinic LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

OK1532 Issued in OK

Legal business name

PAWNEE HEALTH & WELLNESS CLINIC LLC

Practice address

304 Boulder St
Pawnee, OK 74058-4028

Phone

(918) 762-3601

Fax

(918) 762-2544

NPI assigned

Dec 14, 2011

Last updated

Apr 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gordon Page Laird, D.O.

Title

Owner

Phone

(918) 762-3601

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1174892590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 BOULDER ST",
            "city": "PAWNEE",
            "state": "OK",
            "postal_code": "740584028",
            "telephone_number": "918-762-3601",
            "fax_number": "918-762-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 BOULDER ST",
            "city": "PAWNEE",
            "state": "OK",
            "postal_code": "740584028",
            "telephone_number": "918-762-3601",
            "fax_number": "918-762-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAWNEE HEALTH & WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "LAIRD",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "PAGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-762-3601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA763",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OK",
            "license": "OK1532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pawnee Hillcrest Pharmacy Enterprises, LLC
• Pawnee IHS Pharmacy
• Pawnee Indian Health Center
• Pawnee Municipal Hopsital (Caring Hands Hospice)
• Pawnee Municipal Hospital Authority (Pawnee Municipal Hospital)

• General Practice Physician in Pawnee, OK
• Providers in Pawnee, OK by specialty
• General Practice Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.