| Premise Health Of Oklahoma Medical, P.c. | |
|
1 Valero Way Ardmore OK 73401-1615 | |
| (580) 221-6690 | |
| (580) 221-6695 |
| Full Name | Premise Health Of Oklahoma Medical, P.c. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1 Valero Way, Ardmore, Oklahoma |
| Authorized Official Name and Position | Jonathan B Leizman (PRESIDENT) |
| Authorized Official Contact | 6154686270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Oklahoma Medical, P.c. 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Oklahoma Medical, P.c. 1 Valero Way Ardmore OK 73401-1615 Ph: (580) 221-6690 |
| NPI Number | 1275360273 |
|---|---|
| Provider Enumeration Date | 09/16/2024 |
| Last Update Date | 09/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275360273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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