Provider Demographics
NPI:1023601093
Name:WEATHERFORD HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:WEATHERFORD HOSPITAL AUTHORITY
Other - Org Name:
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:580-774-4762
Mailing Address - Fax:
Practice Address - Street 1:3739 LEGACY
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-9746
Practice Address - Country:US
Practice Address - Phone:580-774-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEATHERFORD HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty