# GKS MILBURN CLINIC LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1720651904
- **Authorized official:** STEPHEN KHOURY DO (OWNER)
- **Authorized official phone:** (580) 775-2332

## Contact information

- **Practice address:** 104 W F AVE, MILBURN, OK 73450-1504
- **Practice address phone:** (580) 443-3533
- **Mailing address:** PO BOX 67, MILBURN, OK 73450-0067
- **Mailing address phone:** (580) 443-3533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/23/2021
- **Last updated:** 07/23/2021