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4411 W Gore Blvd Suite A2 Lawton OK 73505 | |
(580) 355-0575 | |
(580) 248-1725 |
Full Name | |
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Speciality | Clinic/center |
Location | 4411 W Gore Blvd, Lawton, Oklahoma |
Authorized Official Name and Position | Brent Smith (CFO) |
Authorized Official Contact | 5803558620 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 785 Lawton OK 73502 Ph: (580) 357-9984 | 4411 W Gore Blvd Suite A2 Lawton OK 73505 Ph: (580) 355-0575 |
NPI Number | 1053337428 |
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Provider Enumeration Date | 07/15/2006 |
Last Update Date | 05/08/2015 |
Identifier | Type | State | Issuer |
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1053337428 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 18333 (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 |