Provider Demographics
NPI:1649218637
Name:SOUTHERN OKLAHOMA WOMEN'S HEALTH
Entity Type:Organization
Organization Name:SOUTHERN OKLAHOMA WOMEN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACOG
Authorized Official - Phone:580-224-9000
Mailing Address - Street 1:731 12TH AVE NW, STE 201
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-5705
Mailing Address - Country:US
Mailing Address - Phone:580-224-9000
Mailing Address - Fax:580-224-9009
Practice Address - Street 1:731 12TH AVE NW
Practice Address - Street 2:SUITE #201
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5705
Practice Address - Country:US
Practice Address - Phone:580-224-9000
Practice Address - Fax:580-224-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27429207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200269340AMedicaid
OK200269340AMedicaid
OKDE5563OtherMEDICARE RAILROAD