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Organization

SOUTHWESTERN MEDICAL CENTER

Active
Parent organization
SOUTHWESTERN MEDICAL CENTER, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTHWESTERN MEDICAL CENTER, LLC
Authorized official
JOHNETTA TRAYLOR (AO)
(502) 596-6063
Entity
Organization

Contact information

Practice address
5602 SW LEE BLVD, LAWTON, OK 73505-9635
(580) 531-4700
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 596-6063

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
2231
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100697950F
OK
Enumeration date
10/31/2006
Last updated
06/26/2025
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