| 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 |