Hydro Medical Clinic PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3099 Issued in OK

Legal business name

HYDRO MEDICAL CLINIC PLLC

Practice address

579 N Broadway Ave
Hydro, OK 73048-8425

Phone

(405) 663-2291

Fax

(405) 663-2191

NPI assigned

Nov 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Brenda Ruth Stutzman, DONPI 1700880127

Title

Owner

Phone

(405) 663-2291

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

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

• Brenda R. Stutzman, D.O.

  • Family Medicine Physician
  • Hydro, OK
  • NPI 1700880127
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1447404868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 N BROADWAY AVE",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "730488425",
            "telephone_number": "405-663-2291",
            "fax_number": "405-663-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 N BROADWAY AVE",
            "city": "HYDRO",
            "state": "OK",
            "postal_code": "730488425",
            "telephone_number": "405-663-2291",
            "fax_number": "405-663-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDRO MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "STUTZMAN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-663-2291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deer Creek Pharmacy Services Inc
• Angelica Maria Exinia, MSW, LCSW
• Faith Christian Fellowship (Care Case Management)
• Russell Allen Fanning, PTA
• James Gichuki, MS
• Hydro-Eakly Public Schools
• Johna K. Roof, P. C. (Continuing Care and Compounding)
• Jerald Andrew Lee
• Amber Dawnell McCormick, COTA
• Oklahoma West Physicians Group

• Family Medicine Physician in Hydro, OK
• Providers in Hydro, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.