Basic Information
| Provider Information | |||||||||
| NPI: | 1700993797 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WAPITI ORTHOPEDICS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 632 | ||||||||
| Address2: | |||||||||
| City: | MADILL | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5807950191 | ||||||||
| FaxNumber: | 5807950194 | ||||||||
| Practice Location | |||||||||
| Address1: | #1 HOSPITAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | MADILL | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5807950216 | ||||||||
| FaxNumber: | 5807950394 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CUMMING | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5807950191 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.