# LAFAVE MELTON MEDICAL INC

> 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:** LAFAVE FAMILY CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912470949
- **Authorized official:** LINDA GRIGG (CREDENTIALING)
- **Authorized official phone:** (580) 399-3552

## Contact information

- **Practice address:** 501 E CONWAY, ALLEN, OK 74825-2904
- **Practice address phone:** (580) 279-5169
- **Mailing address:** 501 E CONWAY, ALLEN, OK 74825-2904
- **Mailing address phone:** (580) 279-5169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/02/2019
- **Last updated:** 01/25/2019