# CHANDLER OUTREACH MEDICAL CENTER

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

## Provider details

- **NPI number:** 1568407476
- **Authorized official:** KRISTIN SELLS P.A. (DIRECTOR)
- **Authorized official phone:** (405) 258-5252

## Contact information

- **Practice address:** 1406 MANVEL AVE, STE C, CHANDLER, OK 74834-4438
- **Practice address phone:** (405) 258-5252
- **Practice address fax:** (405) 258-5552
- **Mailing address:** PO BOX 108810, OKLAHOMA CITY, OK 73101-8810
- **Mailing address phone:** (405) 608-3800
- **Mailing address fax:** (405) 608-3838

## Taxonomy

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

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 08/22/2020