CADDO FAMILY MEDICINE CLINIC – NPI #1477899532
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

CADDO FAMILY MEDICINE CLINIC is a provider located in CADDO, OK. NPPES has assigned the NPI number 1477899532 to CADDO FAMILY MEDICINE CLINIC on December 18, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CADDO FAMILY MEDICINE CLINIC” is a dba name, the actual legal business name for this organization is MEDICINE WHEEL INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 12 years ago on May 20, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CADDO FAMILY MEDICINE CLINIC below.

NPI Profile for
MEDICINE WHEEL INC

NPI Number
1477899532
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MEDICINE WHEEL INC
Doing Business As (dba): CADDO FAMILY MEDICINE CLINIC
Primary location
128 BUFFALO STREET
CADDO, OK 74729
Phone: (580) 367-2100 Fax: (580) 367-2103
Mailing address
PO BOX 146
CADDO, OK 74729-0146
Phone: (580) 367-2100 Fax: (580) 367-2103
Organization Subpart
No
Authorized Official
PAUL WEATHERS
MEDICAL DIRECTOR
Phone: (580) 367-2100
Updated
Identifiers

Identifiers for CADDO FAMILY MEDICINE CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDOK200328450A
MEDICAIDOK200328450B
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)
OK 2982
207P00000X
- Emergency Medicine
OK 2982

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.