Provider Demographics
NPI:1346421799
Name:OKLAHOMA WEST PHYSICIANS GROUP
Entity Type:Organization
Organization Name:OKLAHOMA WEST PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUSER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:580-772-5533
Mailing Address - Street 1:PO BOX 627
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-0627
Mailing Address - Country:US
Mailing Address - Phone:580-772-5533
Mailing Address - Fax:580-772-8737
Practice Address - Street 1:523 E FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-5337
Practice Address - Country:US
Practice Address - Phone:580-772-5533
Practice Address - Fax:580-772-8737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7284207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1D100745100BMedicaid
OKD39229Medicare UPIN