| NPI | 1871032094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA MARIE BEAIR BUTLER Medical Director 918-631-2241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 5195) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 5195) |
| 363AM0700X Physician Assistant, Medical (Licence: OK 2767) | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |