| NPI | 1831595032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED CARTER GLIDEWELL Owner 918-893-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 28027) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: OK 28027) |
| Enumeration Date | 2014-11-15 |
| Last Update Date | 2015-11-14 |