Granite Family Medical Clinic | |
417 N. Main Granite OK 73547 | |
(580) 535-4598 | |
(580) 535-4725 |
Full Name | Granite Family Medical Clinic |
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Speciality | Clinic/center - Primary Care |
Location | 417 N. Main, Granite, Oklahoma |
Authorized Official Name and Position | Nicole Evans (PRESIDENT) |
Authorized Official Contact | 5807060113 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Granite Family Medical Clinic 417 North Main P.o. Box 243 Granite OK 73547-0243 Ph: (580) 535-4598 | Granite Family Medical Clinic 417 N. Main Granite OK 73547 Ph: (580) 535-4598 |
NPI Number | 1396911830 |
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Provider Enumeration Date | 05/05/2008 |
Last Update Date | 08/25/2010 |
Identifier | Type | State | Issuer |
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1396911830 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (Oklahoma) | Primary |
363A00000X | Physician Assistant | 802 (Oklahoma) | Secondary |