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Organization
FAIRVIEW REGIONAL MEDICAL CENTER AUTHORITY
Active
Organization
FAIRVIEW REGIONAL MEDICAL CENTER AUTHORITY
Active
Parent organization
FAIRVIEW REGIONAL MEDICAL CENTER AUTHORITY
Other names
Fairview Family Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRVIEW REGIONAL MEDICAL CENTER AUTHORITY
Authorized official
ROGER KNAK (ADMINISTRATOR)
(580) 227-3721
Entity
Organization
Contact information
Practice address
519 E STATE RD, FAIRVIEW, OK 73737-1458
(580) 227-3721
(580) 227-2882
Mailing address
PO BOX 548, FAIRVIEW, OK 73737-0548
(580) 227-3721
(580) 227-2882
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700800E
—
OK
Enumeration date
06/29/2006
Last updated
04/23/2015
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