| Madison Clark, Pllc | |
|
711 W Main Street Norman OK 73069 | |
| (405) 882-4960 | |
| Not Available |
| Full Name | Madison Clark, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 711 W Main Street, Norman, Oklahoma |
| Authorized Official Name and Position | Madison Anne Clark (COUNSELOR) |
| Authorized Official Contact | 2144356145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Clark, Pllc 1213 Leslie Ln Norman OK 73069-4403 Ph: (214) 435-6145 | Madison Clark, Pllc 711 W Main Street Norman OK 73069 Ph: (405) 882-4960 |
| NPI Number | 1881014926 |
|---|---|
| Provider Enumeration Date | 04/16/2014 |
| Last Update Date | 05/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881014926 | NPI | - | NPPES |
| 1407195183 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5327 (Oklahoma) | Primary |
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