Medicine Wheel Inc
Organization Active NPI General Practice Physician · Caddo, OK
NPI 1477899532 · NPPES record last updated May 20, 2014
Key facts
- NPI
- 1477899532
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 2982 (OK)
- Legal business name
- MEDICINE WHEEL INC
- Practice address
- 128 Buffalo Street
Caddo, OK 74729 - Phone
- (580) 367-2100
- Fax
- (580) 367-2103
- NPI assigned
- Dec 18, 2012
- Organization subpart
- No
Authorized official
- Name
- Paul E Weathers, DO
- Title
- Medical Director
- Phone
- (580) 367-2100
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Caddo Family Medicine Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | 2982 | OK | |
| General Practice Physician |
208D00000X | 2982 | OK | Yes |
Addresses
Primary practice location
128 Buffalo Street
Caddo, OK 74729
Mailing address
PO Box 146
Caddo, OK 74729-0146
Phone (580) 367-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200328450A | Medicaid | OK | |
| 200328450B | Medicaid | OK |
Other names
- Caddo Family Medicine Clinic
Other providers in Caddo, OK
- Kari Kamay Harman
- April Denise Hinkle
- Jill Love
- Janet Lee McBride
- Medicine Wheel Inc
- Dustin O'Hern
- Onesource LLC
- Alicia Pettett
All providers in Caddo, OK · General Practice Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.