| NPI | 1174547632 |
|---|---|
| Doing Business As | MEMORIAL MEDICAL GROUP FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | DAVID BLACKMON CFO 580-355-8620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 22720) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2013-09-24 |