Provider Demographics
NPI:1225782444
Name:WHOLE WOMAN'S HEALTH OF OKLAHOMA LLC
Entity Type:Organization
Organization Name:WHOLE WOMAN'S HEALTH OF OKLAHOMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGSTROM MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-422-0216
Mailing Address - Street 1:1001 E MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5381
Mailing Address - Country:US
Mailing Address - Phone:434-422-2061
Mailing Address - Fax:210-881-6582
Practice Address - Street 1:2453 WILCOX DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-3956
Practice Address - Country:US
Practice Address - Phone:434-422-2061
Practice Address - Fax:210-881-6582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty