| NPI | 1023063997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC JASON DAVIS Owner / Physician 580-310-9510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 3540) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-08-22 |