| NPI | 1366589608 |
|---|---|
| Doing Business As | JAY FAMILY MEDICINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | RICHARD H TIDWELL Owner 918-253-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 18708) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2008-04-20 |