OrganizationActive
Gwen Fuentes MD Pediatric Clinic
NPI 1083830608 · Medical Specialty Clinic/Center · Ardmore, OK
Provider details
- NPI number
- 1083830608
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Gwen Fuentes, Owner(580) 223-5693
- License
- 13171 (OK)
Specialties & taxonomies
Ambulatory Health Care Facilities
Allopathic & Osteopathic Physicians
Practice location
919 15th Ave Nw
Ardmore, OK 73401-1809
Phone: (580) 223-5693
Fax: (580) 223-8909
Approximate (ZIP-level) locationGet directions
Mailing address
919 15th Ave Nw
Ardmore, OK 73401-1809
Registry dates
- Enumerated
- 2007-04-18
- Last updated
- 2011-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.