Provider Demographics
NPI:1275566358
Name:ANDREWS, WESLEY (MD)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:O S U STUDENT HEALTH SERVICE
Mailing Address - Street 2:1202 W. FARM ROAD
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74078-2036
Mailing Address - Country:US
Mailing Address - Phone:405-744-7665
Mailing Address - Fax:405-744-6556
Practice Address - Street 1:O S U STUDENT HEALTH SERVICE
Practice Address - Street 2:1202 W. FARM ROAD
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74078-2036
Practice Address - Country:US
Practice Address - Phone:405-744-7665
Practice Address - Fax:405-744-6556
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G14402Medicare UPIN