# PERRY MEMORIAL HOSPITAL AUTHORITY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Community Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861942948
- **Authorized official:** MR. JOHN FULLER (CHAIRMAN OF THE BOARD)
- **Authorized official phone:** (580) 336-2176

## Contact information

- **Practice address:** 501 N 14TH ST, PERRY, OK 73077-5021
- **Practice address phone:** (580) 336-2176
- **Practice address fax:** (580) 336-3178
- **Mailing address:** 1318 ELM ST, PERRY, OK 73077-5034

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2268 | OK | Yes |

## Other

- **Enumeration date:** 10/12/2016
- **Last updated:** 10/12/2016