Individual
DR. MONTY J GRUGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1301 E LINCOLN RD, IDABEL, OK 74745-7300
(580) 208-3121
(580) 208-3193
Mailing address
117 N BROADWAY ST, BROKEN BOW, OK 74728-3933
(580) 208-3121
(580) 208-3193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4146
OK
Other
Enumeration date
03/24/2006
Last updated
12/30/2016
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