Southwest Oklahoma Family Practice | |
1202 Nw Arlington Ave Lawton OK 73507-6537 | |
(580) 248-2288 | |
(580) 248-5757 |
Full Name | Southwest Oklahoma Family Practice |
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Speciality | Family Medicine |
Location | 1202 Nw Arlington Ave, Lawton, Oklahoma |
Authorized Official Name and Position | Brian Maddy (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 4052713932 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southwest Oklahoma Family Practice 1202 Nw Arlington Ave Lawton OK 73507-6537 Ph: (580) 248-2288 | Southwest Oklahoma Family Practice 1202 Nw Arlington Ave Lawton OK 73507-6537 Ph: (580) 248-2288 |
NPI Number | 1790893097 |
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Provider Enumeration Date | 08/27/2006 |
Last Update Date | 05/02/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790893097 | NPI | - | NPPES |
200021490C | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Oklahoma) | Primary |
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