Broken Arrow Womens Clinic Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OK9927 Issued in OK

Legal business name

BROKEN ARROW WOMENS CLINIC INC

Practice address

2950 S Elm Place
Suite 325
Broken Arrow, OK 74012

Phone

(918) 449-4034

Fax

(918) 449-4039

NPI assigned

Oct 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Dick Lynn Glick, MD

Title

Owner

Phone

(918) 449-4034

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1346429396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 S ELM PLACE",
            "address_2": "SUITE 325",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-449-4034",
            "fax_number": "918-449-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 S ELM PLACE",
            "address_2": "SUITE 325",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-449-4034",
            "fax_number": "918-449-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN ARROW WOMENS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "DICK",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-449-4034",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "OK9927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Broken Arrow Public Schools
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• Broken Arrow, LLC
• Brookdale Senior Living Communities, Inc.
• Brooks Unlimited LLC
• Damon Lee Brooks, D.O.
• John David Brooks III

• Obstetrics & Gynecology Physician in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Obstetrics & Gynecology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.