| NPI | 1659647501 |
|---|---|
| Doing Business As | MEMORIAL MEDICAL GROUP FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DAVID BLACKMON CFO 580-355-8620 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2012-03-26 |