Basic Information
Provider Information
NPI: 1518906429
EntityType: 2
ReplacementNPI:  
OrganizationName: WEATHERFORD INPATIENT PHYSICIAN ASSOCIATION, P. A.
LastName:  
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Credential:  
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Mailing Information
Address1: 713 E ANDERSON ST
Address2:  
City: WEATHERFORD
State: TX
PostalCode: 760865705
CountryCode: US
TelephoneNumber: 8175991780
FaxNumber: 8175991781
Practice Location
Address1: 713 E ANDERSON ST
Address2:  
City: WEATHERFORD
State: TX
PostalCode: 760865705
CountryCode: US
TelephoneNumber: 8175991780
FaxNumber: 8175991781
Other Information
ProviderEnumerationDate: 06/06/2006
LastUpdateDate: 01/31/2012
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: RHEAMS
AuthorizedOfficialFirstName: CHRISTOPHER
AuthorizedOfficialMiddleName: N
AuthorizedOfficialTitleorPosition: OWNER/PRESIDENT
AuthorizedOfficialTelephone: 8175991780
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: M. D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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