# FASTCARE MEDICAL CLINIC OF EDMOND

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

## Provider details

- **NPI number:** 1225368350
- **Authorized official:** DEANNA LOUISE WILLIAMS (VP)
- **Authorized official phone:** (405) 942-3737

## Contact information

- **Practice address:** 912 NW 150TH ST, EDMOND, OK 73013-1829
- **Practice address phone:** (405) 418-8660
- **Practice address fax:** (405) 418-8661
- **Mailing address:** PO BOX 14587, OKLAHOMA CITY, OK 73113-0587
- **Mailing address phone:** (405) 942-3737
- **Mailing address fax:** (405) 942-3873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/13/2010
- **Last updated:** 01/13/2010