| NPI | 1174307854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LANCE Billing Manager 918-521-0785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2024-10-02 |