# CENTRAL OKLAHOMA FAMILY MEDICAL CENTER

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

## Provider details

- **NPI number:** 1730347329
- **Authorized official:** MR. CASEY HAROLD ANSON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (580) 925-3286

## Contact information

- **Practice address:** 527 W 3RD ST, KONAWA, OK 74849-1415
- **Practice address phone:** (580) 925-3286
- **Mailing address:** 527 W 3RD ST, KONAWA, OK 74849-1415
- **Mailing address phone:** (580) 925-3286

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385H00000X | Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 05/30/2008
- **Last updated:** 01/31/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100737160S | — | OK |