Organization
MI CLINICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY JOSEPH BIJAK MD (MANAGER)
(505) 270-3823
Entity
Organization
Contact information
Practice address
4200 S MAY AVE STE D, OKLAHOMA CITY, OK 73119-3200
(405) 482-8221
(405) 421-9640
Mailing address
2119 RIVERWALK DR STE 202, MOORE, OK 73160-2700
(405) 482-8221
(405) 421-9640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/09/2018
Last updated
12/23/2020
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