SOUTHWESTERN EMERGENCY DEPARTMENT PHYSICIAN SERVICES, LLC (NPI# 1255344206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255344206 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN EMERGENCY DEPARTMENT PHYSICIAN SERVICES, LLC |
| Practice Address |
5602 Sw Lee Blvd Lawton OK 73505-9635 |
| Mailing Address |
4401 W Memorial Rd Suite 121 Oklahoma City OK 73134-1785 |
| Practice Telephone | 5805314700 |
| Practice Fax Number | 5805314889 |
| Mailing Telephone | 4057514664 |
| Mailing Fax Number | 4057494561 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GEORGE KRUGER (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5805314701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
2231 | OK | Ambulatory Health Care Facilities |
| Street Address |
5602 SW LEE BLVD |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-9635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326044603 | Dennis Dodd | Nurse Anesthetist, Certified Registered | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2005-06-22 |
| 1629531900 | Malaya Reyna Deemer | Nurse Practitioner | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2019-04-12 |
| 1295213106 | Kylie Danielle Starnes | Nurse Practitioner | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2018-08-02 |
| 1669963575 | Catherine H Phipps | Physician Assistant | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2018-05-25 |
| 1558730952 | Deanna Harmon | Registered Nurse | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2015-09-16 |
| 1881909604 | Southwestern Radiology Affiliates, LLC | Radiology | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2010-08-17 |
| 1538472899 | Chad Reid | Family Medicine | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2010-07-15 |
| 1770728412 | Lawton Ems Services, Inc. | Emergency Medicine | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2008-12-10 |
| 1013169531 | Southwestern Surgical Affiliates, LLC | Orthopaedic Surgery | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2008-10-15 |
| 1912186651 | Abdallah M Hussein | Family Medicine | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2007-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306210133 | Today Clinic Pllc | Clinic/Center | 4008 Nw Cache Rd, Lawton, OK 73505-3634 | 2015-11-17 |
| 1720480080 | East Lawton Neighborhood Family Clinic, Pllc | Clinic/Center | 1102 Se 36th St, Ste. B, Lawton, OK 73501-8462 | 2014-09-18 |
| 1487833984 | Prompt Care, P.C. | Clinic/Center | 412 Sw Summit Ave, Lawton, OK 73501-5252 | 2007-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476654 | Team Clinic Management Partners LLC | Clinic/Center | 372 N Cobb, Caney, OK 74533 | 2020-10-29 |
| 1184222705 | Essential Md, Pllc | Clinic/Center | 6316 E 102nd St Ste 100, Tulsa, OK 74137-7061 | 2020-10-15 |
| 1881292191 | Team Clinic Management Partners LLC | Clinic/Center | 3100 W New Orleans St, Broken Arrow, OK 74011-1468 | 2020-10-09 |
| 1972115392 | Team Clinic Management Partners LLC | Clinic/Center | 225 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-18 |
| 1093327413 | Team Clinic Management Partners LLC | Clinic/Center | 301 W New Orleans St, Broken Arrow, OK 74011-2206 | 2020-08-18 |
| 1962013110 | Team Clinic Management Partners LLC | Clinic/Center | 4300 E Gary Street, Broken Arrow, OK 74014 | 2020-08-12 |
| 1750992038 | Team Clinic Management Partners LLC | Clinic/Center | 251 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-11 |
| 1689285975 | Team Clinic Management Partners LLC | Clinic/Center | 301 E Tucson St, Broken Arrow, OK 74011-7235 | 2020-08-11 |
| 1417568700 | Team Clinic Management Partners LLC | Clinic/Center | 1351 E Albany St, Broken Arrow, OK 74012-8995 | 2020-08-11 |
| 1164033569 | Team Clinic Management Partners LLC | Clinic/Center | 6800 E Quincy Pl, Broken Arrow, OK 74014-4523 | 2020-08-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.