| NPI | 1487812871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY MASON Credentialing Coordinator 918-488-6687 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |