| NPI | 1104819762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY CULVER DUBOIS Owner 405-741-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2022-07-21 |