# ALTUS MINOR EMERGENCY & FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1659738953
- **Authorized official:** MS. BRIDGET MOSS APRN (OWNER)
- **Authorized official phone:** (580) 318-0229

## Contact information

- **Practice address:** 916 N MAIN ST, ALTUS, OK 73521-3118
- **Practice address phone:** (580) 318-0229
- **Practice address fax:** (580) 480-0044
- **Mailing address:** 916 N MAIN ST, ALTUS, OK 73521-3118
- **Mailing address phone:** (580) 318-0229
- **Mailing address fax:** (580) 480-0044

## Taxonomy

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

## Other

- **Enumeration date:** 01/19/2016
- **Last updated:** 03/02/2016