| NPI | 1639295066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA J BANKSTON Business Manager 405-755-7672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 21132) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |