Basic Information
| Provider Information | |||||||||
| NPI: | 1457679573 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WESPETAL | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7600 S LEWIS AVE | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741366836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9184937800 | ||||||||
| FaxNumber: | 9184937868 | ||||||||
| Practice Location | |||||||||
| Address1: | 7600 S LEWIS AVE | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741366836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9184937800 | ||||||||
| FaxNumber: | 9184937868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2010 | ||||||||
| LastUpdateDate: | 05/13/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 16317 | OK | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.