Provider Demographics
NPI:1568920924
Name:DIRECT2U URGENT CARE PLLC
Entity Type:Organization
Organization Name:DIRECT2U URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WAGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-274-5551
Mailing Address - Street 1:2417 COUNTY ROAD 1263
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-3123
Mailing Address - Country:US
Mailing Address - Phone:405-274-5551
Mailing Address - Fax:
Practice Address - Street 1:2417 COUNTY ROAD 1263
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-3123
Practice Address - Country:US
Practice Address - Phone:405-274-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty