# PRIMARY CARE CLINIC OF WINDSOR VIEW LLC

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

## Provider details

- **NPI number:** 1659095321
- **Authorized official:** AMIE DEGRAFF (CREDENTIALING MANAGER)
- **Authorized official phone:** (352) 239-6759

## Contact information

- **Practice address:** 4337 NW 50TH ST, OKLAHOMA CITY, OK 73112-2248
- **Practice address phone:** (405) 946-0611
- **Practice address fax:** (405) 941-1957
- **Mailing address:** 10432 NW 34TH ST, YUKON, OK 73099-3573
- **Mailing address phone:** (405) 946-0611
- **Mailing address fax:** (405) 941-1957

## Taxonomy

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

## Other

- **Enumeration date:** 09/27/2022
- **Last updated:** 03/10/2023