| NPI | 1003107863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA RENEE BEACHAM Credentialer 918-808-8235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OK 16121) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2018-06-20 |