| NPI | 1497064182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN BAKER FORE President 580-223-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: OK 2273) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: OK 2273) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |