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Organization
STATE OF OKLAHOMA - OSU CENTER FOR HEALTH SCIENCES COLLEGE OF OSTEOPAT
Active
Organization
STATE OF OKLAHOMA - OSU CENTER FOR HEALTH SCIENCES COLLEGE OF OSTEOPAT
Active
Other names
OSU Enid Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA WILSON (ASSOCIATE DIRECTOR)
(918) 561-8322
Entity
Organization
Contact information
Practice address
1101 E BROADWAY AVE, ENID, OK 73701-4410
(580) 977-5000
(918) 977-5004
Mailing address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 561-5701
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100757080A
—
OK
Enumeration date
12/08/2006
Last updated
06/25/2008
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