Provider Demographics
NPI:1962529636
Name:WHEELCHAIR & SEATING CLINIC OF OKLA
Entity type:Organization
Organization Name:WHEELCHAIR & SEATING CLINIC OF OKLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:ATP
Authorized Official - Phone:918-622-5433
Mailing Address - Street 1:10301 E 51ST ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5804
Mailing Address - Country:US
Mailing Address - Phone:918-622-5433
Mailing Address - Fax:918-622-5448
Practice Address - Street 1:10301 E 51ST ST
Practice Address - Street 2:SUITE E
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-5804
Practice Address - Country:US
Practice Address - Phone:918-622-5433
Practice Address - Fax:918-622-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
OK874599332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1494056OtherAETNA
OK200095550AMedicaid
OK200095550AMedicaid
OK5820150001Medicare NSC