NPI | 1801190061 |
---|---|
Doing Business As | ST ANTHONY HERITAGE FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | CRYSTAL L PENA Insurance Credentialing Specialist 405-272-7452 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2011-01-03 |
Last Update Date | 2011-07-08 |