| Boulevard Family Clinic Llc | |
|
3431 S Boulevard Suite 109 Edmond OK 73013-5475 | |
| (405) 470-1884 | |
| Not Available |
| Full Name | Boulevard Family Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3431 S Boulevard, Edmond, Oklahoma |
| Authorized Official Name and Position | T Denise Cato (ADMINISTRATOR) |
| Authorized Official Contact | 4054701884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulevard Family Clinic Llc 3431 S Boulevard Suite 109 Edmond OK 73013-5475 Ph: (405) 470-1884 | Boulevard Family Clinic Llc 3431 S Boulevard Suite 109 Edmond OK 73013-5475 Ph: (405) 470-1884 |
| NPI Number | 1760774814 |
|---|---|
| Provider Enumeration Date | 05/09/2011 |
| Last Update Date | 05/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760774814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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