Robert L Waddell MD PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20345 Issued in OK

Legal business name

ROBERT L WADDELL MD PC

Practice address

435 N. Monte Vista
Ada, OK 74820-4676

Phone

(580) 310-0102

Fax

(580) 310-0104

NPI assigned

Apr 27, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Robert Luther Waddell, MD

Title

Owner

Phone

(580) 310-0102

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1801030440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1660",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748211660",
            "telephone_number": "580-310-0102",
            "fax_number": "580-310-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N. MONTE VISTA",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204676",
            "telephone_number": "580-310-0102",
            "fax_number": "580-310-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L WADDELL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LUTHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-310-0102",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OK",
            "license": "20345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100155110A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Rinehart
• Lynette Faye Ring, L.M.T., N.M.T.
• Bridget Nicole Risner
• Kimberly Michelle Roark, MD
• Anna M Robbins, M.ED, LPC
• Donny Roberts
• Marlana Robinson, LMT MMP
• Melissa Jill Robinson, MSPS, LBP
• Lori Ann Robson, BA
• Antonio Aaron Rodriguez, MD

• Surgery Physician in Ada, OK
• Providers in Ada, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.