| South Moore Medical Clinic | |
|
14800 S Western Ave Moore OK 73170-7112 | |
| (405) 912-4900 | |
| (405) 912-4903 |
| Full Name | South Moore Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 14800 S Western Ave, Moore, Oklahoma |
| Authorized Official Name and Position | Keith R. Layne (PHYSICIAN) |
| Authorized Official Contact | 4059124900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Moore Medical Clinic Po Box 25887 Oklahoma City OK 73125-0887 Ph: (405) 912-4900 | South Moore Medical Clinic 14800 S Western Ave Moore OK 73170-7112 Ph: (405) 912-4900 |
| NPI Number | 1972545218 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972545218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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