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Organization
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER
Active
Organization
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CASEY HAROLD ANSON (EXECUTIVE DIRECTOR)
(580) 925-3286
Entity
Organization
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100737160S
—
OK
Enumeration date
05/30/2008
Last updated
01/31/2022
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