| |
4121 W Gore Blvd Lawton OK 73505-6336 | |
(580) 699-5511 | |
(580) 699-5519 |
Full Name | |
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Speciality | Family Medicine |
Location | 4121 W Gore Blvd, Lawton, Oklahoma |
Authorized Official Name and Position | Abolghasem Marco Rezaei (OWNER) |
Authorized Official Contact | 5806995511 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4121 W Gore Blvd Lawton OK 73505-6336 Ph: (580) 699-5511 | 4121 W Gore Blvd Lawton OK 73505-6336 Ph: (580) 699-5511 |
NPI Number | 1366538183 |
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Provider Enumeration Date | 10/05/2006 |
Last Update Date | 03/27/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366538183 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 23655 (Oklahoma) | Primary |
Mark W Cotton Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5610 Sw Lee Blvd, Lawton, OK 73505 Phone: 580-536-6600 Fax: 580-536-2427 | |
R. Brent Smith, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4411 W Gore Blvd, Ste. B-5, Lawton, OK 73505 Phone: 580-357-0493 | |
Sooner Inpatient Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3401 W Gore Blvd, Lawton, OK 73505 Phone: 954-838-2371 |