| NPI | 1487638979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ERWIN WOMACK Owner/President 405-946-3373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 10243) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-09-12 |