Waterford Plastic Surgery Center PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

22456 Issued in OK

Legal business name

WATERFORD PLASTIC SURGERY CENTER PLLC

Practice address

6305 Waterford Blvd Ste 115
Oklahoma City, OK 73118-1116

Phone

(405) 848-3459

Fax

(405) 848-5401

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Justin M Jones, MD

Title

President

Phone

(405) 848-3459

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1265524953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6305 WATERFORD BLVD STE 115",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731181116",
            "telephone_number": "405-848-3459",
            "fax_number": "405-848-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6305 WATERFORD BLVD STE 115",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731181116",
            "telephone_number": "405-848-3459",
            "fax_number": "405-848-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFORD PLASTIC SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-848-3459",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "22456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanyanita Washington
• Emma Wassilak, M.ED., LPC
• Anita Wasson
• Deanna Wasson, MSW
• Ajla Tasleem Wasti, MD
• Watermark Canterbury, LLC (The Fountains at Canterbury)
• Dan Neal Waters, MD
• Diana G Waters, PH. D.
• Liberty Waters
• Natalie Nicole Waters

• Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.