| NPI | 1225388218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE MARIE WILSON Physician Owner 580-504-8084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 3394) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2012-09-17 |