First Med Clinic S 104th Llc | |
1140 Sw 104th St Oklahoma City OK 73139-2992 | |
(405) 691-3100 | |
(405) 691-3106 |
Full Name | First Med Clinic S 104th Llc |
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Speciality | Family Medicine |
Location | 1140 Sw 104th St, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Todd Lechtenberger (CEO) |
Authorized Official Contact | 4054716400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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First Med Clinic S 104th Llc 1221 N Kelly Ave Edmond OK 73003-4865 Ph: (405) 471-6400 | First Med Clinic S 104th Llc 1140 Sw 104th St Oklahoma City OK 73139-2992 Ph: (405) 691-3100 |
NPI Number | 1942649520 |
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Provider Enumeration Date | 06/18/2013 |
Last Update Date | 06/18/2013 |
Identifier | Type | State | Issuer |
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1942649520 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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