| NPI | 1437471166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED M INGRAM Physician/President 918-371-5885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 2098) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2010-02-22 |