# AFFORDABLE WEIGHT LOSS AND PAIN MANAGEMENT CLINIC PLLC

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

## Provider details

- **NPI number:** 1730428939
- **Authorized official:** JARRETT GORDON GREGORY MD (OWNER)
- **Authorized official phone:** (580) 224-2669

## Contact information

- **Practice address:** 810 W BROADWAY ST, ARDMORE, OK 73401-4527
- **Practice address phone:** (580) 224-2669
- **Practice address fax:** (580) 319-5294
- **Mailing address:** 810 W BROADWAY ST, ARDMORE, OK 73401-4527
- **Mailing address phone:** (580) 224-2669
- **Mailing address fax:** (580) 319-5294

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | 13611 | OK | Yes |

## Other

- **Enumeration date:** 02/07/2013
- **Last updated:** 02/07/2013