Agape' Wellness Center & Wound Care, LLC

Organization Active NPI Family Medicine Physician · Estate Clifton Hill, VI

NPI 1750429148 · NPPES record last updated Aug 24, 2026

Key facts

NPI
1750429148
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
23898 (OK)
Legal business name
AGAPE' WELLNESS CENTER & WOUND CARE, LLC
Practice address
5401 Eddie Ortiz Drive
Estate Clifton Hill, VI 00850
Phone
(340) 778-1932
Fax
(340) 778-1935
NPI assigned
Feb 1, 2007
Organization subpart
No

Authorized official

Name
Dr. Hubert H Watty, M.D
Title
Owner / Manager
Phone
(918) 869-3466

Practitioners 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190314002493 VI Part B Supplier - Clinic/Group Practice 4688699705 Receives reassigned benefits from 1 practitioner
Practice locations: Kingshill, VI

National Provider Directory

Locations

202 N 37th St
Muskogee, OK 74401
Phone (918) 681-4400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 23898 OK Yes

Addresses

Primary practice location

5401 Eddie Ortiz Drive
Estate Clifton Hill, VI 00850

Mailing address

9281 Clifton HL
Kingshill, VI 00850-9640
Phone (340) 778-1932

Sources for this page

Verify at the official NPI Registry.