| Southwestern Emergency Department Physician Services, Llc | |
|
5602 Sw Lee Blvd Lawton OK 73505-9635 | |
| (580) 531-4700 | |
| (580) 531-4889 |
| Full Name | Southwestern Emergency Department Physician Services, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5602 Sw Lee Blvd, Lawton, Oklahoma |
| Authorized Official Name and Position | George Kruger (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5805314701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwestern Emergency Department Physician Services, Llc 4401 W Memorial Rd Suite 121 Oklahoma City OK 73134-1785 Ph: (405) 751-4664 | Southwestern Emergency Department Physician Services, Llc 5602 Sw Lee Blvd Lawton OK 73505-9635 Ph: (580) 531-4700 |
| NPI Number | 1255344206 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255344206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2231 (Oklahoma) | Primary |
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