| Keith Ob/gyn Clinic | |
|
1901 W 3rd St Suite B Elk City OK 73644-4337 | |
| (580) 225-1086 | |
| (580) 225-2429 |
| Full Name | Keith Ob/gyn Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 1901 W 3rd St, Elk City, Oklahoma |
| Authorized Official Name and Position | Roy L Ikner (CEO) |
| Authorized Official Contact | 5802252511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Ob/gyn Clinic 1901 W 3rd St Suite B Elk City OK 73644-4337 Ph: (580) 225-1086 | Keith Ob/gyn Clinic 1901 W 3rd St Suite B Elk City OK 73644-4337 Ph: (580) 225-1086 |
| NPI Number | 1073759403 |
|---|---|
| Provider Enumeration Date | 01/07/2009 |
| Last Update Date | 03/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073759403 | NPI | - | NPPES |
| 13625 | Other | OK | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2210 (Oklahoma) | Primary |
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