Provider Demographics
NPI:1811941149
Name:WESTERN, MARGARET MARY (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARY
Last Name:WESTERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 WANDA ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OK
Mailing Address - Zip Code:73448-1229
Mailing Address - Country:US
Mailing Address - Phone:580-276-2400
Mailing Address - Fax:580-276-4358
Practice Address - Street 1:429 E OLIVE ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-4747
Practice Address - Country:US
Practice Address - Phone:575-544-8209
Practice Address - Fax:575-546-7408
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2005-0767207Q00000X
OK31055207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM96252782Medicaid
NM96252782Medicaid