NPI | 1942435672 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL ECHELLE CEO 918-426-2442 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
363AM0700X Physician Assistant, Medical (Licence: OK 533) | |
Enumeration Date | 2009-05-26 |
Last Update Date | 2025-07-02 |