Provider Demographics
NPI:1033543863
Name:WEIR ASC LLC
Entity Type:Organization
Organization Name:WEIR ASC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-703-1138
Mailing Address - Street 1:9913 S MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7017
Mailing Address - Country:US
Mailing Address - Phone:405-703-1138
Mailing Address - Fax:405-703-1270
Practice Address - Street 1:9840 EAST 81 ST
Practice Address - Street 2:SUITE 200
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133
Practice Address - Country:US
Practice Address - Phone:405-703-1138
Practice Address - Fax:405-703-1270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEIR ACS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical