Provider Demographics
NPI:1699750554
Name:HUSER, J M III (MD)
Entity type:Individual
Prefix:DR
First Name:J
Middle Name:M
Last Name:HUSER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 LEGACY ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-5337
Mailing Address - Country:US
Mailing Address - Phone:580-772-3331
Mailing Address - Fax:580-774-1451
Practice Address - Street 1:3725 LEGACY ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-5337
Practice Address - Country:US
Practice Address - Phone:580-772-3331
Practice Address - Fax:580-774-1451
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17208207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100252270AMedicaid
OK100090820AMedicaid
OK100252270AMedicaid