| Tishomingo Doctor's Medical Clinic, Pc | |
|
508 E 24th St Tishomingo OK 73460-3214 | |
| (580) 371-9117 | |
| (580) 371-3170 |
| Full Name | Tishomingo Doctor's Medical Clinic, Pc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 508 E 24th St, Tishomingo, Oklahoma |
| Authorized Official Name and Position | Virginia Ragan (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 5803719117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tishomingo Doctor's Medical Clinic, Pc 508 E 24th St Tishomingo OK 73460-3214 Ph: (580) 371-9117 | Tishomingo Doctor's Medical Clinic, Pc 508 E 24th St Tishomingo OK 73460-3214 Ph: (580) 371-9117 |
| NPI Number | 1508096447 |
|---|---|
| Provider Enumeration Date | 07/24/2009 |
| Last Update Date | 11/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508096447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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