# URGENT CARE AND FAMILY PRACTICE CENTER OF PONCA CITY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154529865
- **Authorized official:** DR. JAN RUSSELL HILL M.D. (OWNER)
- **Authorized official phone:** (580) 762-9292

## Contact information

- **Practice address:** 1715 N 5TH ST, PONCA CITY, OK 74601-2763
- **Practice address phone:** (580) 762-9292
- **Practice address fax:** (580) 762-1660
- **Mailing address:** 1715 N 5TH ST, PONCA CITY, OK 74601-2763
- **Mailing address phone:** (580) 762-9292
- **Mailing address fax:** (580) 762-1660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 19188 | OK | Yes |

## Other

- **Enumeration date:** 07/03/2007
- **Last updated:** 11/15/2010