# CORNERSTONE FAMILY MEDICINE PLLC

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

## Provider details

- **NPI number:** 1376257832
- **Authorized official:** KEENAN FERGUSON DO (OWNER/PHYSICIAN)
- **Authorized official phone:** (580) 254-5316

## Contact information

- **Practice address:** 4902 OKLAHOMA AVE, WOODWARD, OK 73801-3713
- **Practice address phone:** (580) 254-5316
- **Practice address fax:** (580) 254-0130
- **Mailing address:** 3100 DOWNS AVE, WOODWARD, OK 73801-5328
- **Mailing address phone:** (580) 254-5316
- **Mailing address fax:** (580) 254-0130

## Taxonomy

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

## Other

- **Enumeration date:** 01/10/2023
- **Last updated:** 01/10/2023