Full Name | |
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Speciality | Physician Assistant |
Location | 103 W Main, Ringling, Oklahoma |
Authorized Official Name and Position | Bobby G. Thompson (PRESIDENT & CEO) |
Authorized Official Contact | 5802206611 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4401 W Memorial Rd Suite #141, Attention Becky Oklahoma City OK 73134-1785 Ph: (405) 936-5800 | 103 W Main Ringling OK 73456 Ph: (580) 662-2078 |
NPI Number | 1740357011 |
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Provider Enumeration Date | 11/29/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740357011 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
363A00000X | Physician Assistant | (* (Not Available)) | Primary |