Provider Demographics
NPI:1083653919
Name:KENT H WEBB MD PLLC
Entity Type:Organization
Organization Name:KENT H WEBB MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-632-4616
Mailing Address - Street 1:1000 SW 44TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3629
Mailing Address - Country:US
Mailing Address - Phone:405-632-4616
Mailing Address - Fax:405-631-1550
Practice Address - Street 1:1000 SW 44TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3630
Practice Address - Country:US
Practice Address - Phone:405-632-4616
Practice Address - Fax:405-631-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200026760AMedicaid
OK1033229240OtherSURGICAL HOSPITAL OF OKLAHOMA
OK444668180004OtherBCBS
OK1033229240OtherSURGICAL HOSPITAL OF OKLAHOMA
OK200026760AMedicaid