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Organization
PERRY MEMORIAL HOSPITAL AUTHORITY
Active
Organization
PERRY MEMORIAL HOSPITAL AUTHORITY
Active
Other names
Community Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN FULLER (CHAIRMAN OF THE BOARD)
(580) 336-2176
Entity
Organization
Contact information
Practice address
501 N 14TH ST, PERRY, OK 73077-5021
(580) 336-2176
(580) 336-3178
Mailing address
1318 ELM ST, PERRY, OK 73077-5034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2268
OK
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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