NPI | 1346266731 |
---|---|
Doing Business As | MEMORIAL MEDICAL GROUP INTERNAL MEDICINE CLINIC |
Entity Type | Organization |
Authorized Contact | BRENT SMITH CEO 580-585-5511 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 17722) |
Enumeration Date | 2006-07-15 |
Last Update Date | 2024-01-10 |