| Purdom Surgery Clinic | |
|
1800 W 1st St Suite 3 Elk City OK 73644-3133 | |
| (580) 225-4699 | |
| (580) 243-6823 |
| Full Name | Purdom Surgery Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 1800 W 1st 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 |
|---|---|
| Purdom Surgery Clinic 1800 W 1st St Suite 3 Elk City OK 73644-3133 Ph: (580) 225-4699 | Purdom Surgery Clinic 1800 W 1st St Suite 3 Elk City OK 73644-3133 Ph: (580) 225-4699 |
| NPI Number | 1679711592 |
|---|---|
| Provider Enumeration Date | 01/30/2009 |
| Last Update Date | 03/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679711592 | NPI | - | NPPES |
| 2210 | Other | OK | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2210 (Oklahoma) | Primary |
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