NPI | 1770058133 |
---|---|
Entity Type | Organization |
Authorized Contact | BRETT CAUTHEN Member 405-631-0611 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2018-10-11 |
Last Update Date | 2018-10-11 |