# FAMILY MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SEAN BOONE DO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295778074
- **Authorized official:** DR. SEAN D BOONE D.O. (SOLE PROPRIETOR)
- **Authorized official phone:** (580) 326-6111

## Contact information

- **Practice address:** 1405 E KIRK ST, SUITE B, HUGO, OK 74743-3603
- **Practice address phone:** (580) 326-6111
- **Practice address fax:** (580) 326-0469
- **Mailing address:** 1405 E KIRK ST, SUITE B, HUGO, OK 74743-3603
- **Mailing address phone:** (580) 326-6111
- **Mailing address fax:** (580) 326-0469

## Taxonomy

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

## Other

- **Enumeration date:** 06/13/2006
- **Last updated:** 06/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100708320A | — | OK |