| NPI | 1245411727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHONDA RENEE DIXON Practice Manager 405-686-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OK 21473) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2012-08-21 |