| NPI | 1164646436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI L SUTTON Office Administrator 918-369-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 2401) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |