| NPI | 1386253862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH DAVIS Office Manager 918-426-2442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2025-03-25 |