Organization
SURGERY CENTER OF LAWTON PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA WILLIAMS (ADMINISTRATOR)
(580) 351-0500
Entity
Organization
Contact information
Practice address
3617 W GORE BLVD, SUITE D, LAWTON, OK 73505-6373
(580) 351-0500
(580) 351-0500
Mailing address
3617 W GORE BLVD, SUITE D, LAWTON, OK 73505-6373
(580) 351-0500
(580) 351-0500
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0030
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100745750 A
—
OK
Enumeration date
05/25/2006
Last updated
03/27/2012
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