Organization
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER
Active
Organization
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASEY LEE BRUNDIDGE MPA (PA-C)
(580) 925-3266
Entity
Organization
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3266
(580) 925-9149
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3266
(580) 925-9149
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1618
OK
Other
Enumeration date
02/28/2007
Last updated
08/22/2020
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