| NPI | 1457166522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIS PHILLIPS Compliance Officer 918-295-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-02-07 |
| Last Update Date | 2025-02-07 |