| NPI | 1578714721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSIE J CHEADLE Billing Supervisor 405-705-0018 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: OK 16447) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |