Provider Demographics
NPI:1245303510
Name:WEWOKA REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:WEWOKA REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-257-9055
Mailing Address - Street 1:1402 S INDIAN RD
Mailing Address - Street 2:
Mailing Address - City:WEWOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74884-9780
Mailing Address - Country:US
Mailing Address - Phone:405-257-9055
Mailing Address - Fax:405-257-9951
Practice Address - Street 1:1402 S INDIAN RD
Practice Address - Street 2:
Practice Address - City:WEWOKA
Practice Address - State:OK
Practice Address - Zip Code:74884-9780
Practice Address - Country:US
Practice Address - Phone:405-257-9055
Practice Address - Fax:405-257-9951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty