Organization
TRIAD HEALTH SYSTEMS LLC
Active
Other names
TRIAD COMPLETE HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BEVERLEY (BILLING MANAGER)
(580) 765-9451
Entity
Organization
Contact information
Practice address
2703 N 14TH ST, PONCA CITY, OK 74601
(580) 765-9451
Mailing address
2703 N 14TH ST, PONCA CITY, OK 74601
(580) 765-9451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/27/2020
Last updated
06/08/2020
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