Provider Demographics
NPI:1528617172
Name:WEATHERFORD HOSPIAL AUTHORITY
Entity type:Organization
Organization Name:WEATHERFORD HOSPIAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGANNA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:BUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-774-4762
Mailing Address - Street 1:3701 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-3309
Mailing Address - Country:US
Mailing Address - Phone:580-772-5551
Mailing Address - Fax:580-774-2314
Practice Address - Street 1:213 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-5437
Practice Address - Country:US
Practice Address - Phone:580-774-5089
Practice Address - Fax:580-774-5067
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEATHERFORD HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-06
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center