Organization
FRED M. INGRAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED M INGRAM D.O. (PHYSICIAN/PRESIDENT)
(918) 371-5885
Entity
Organization
Contact information
Practice address
1205 W MAIN ST, COLLINSVILLE, OK 74021-3114
(918) 371-5885
(918) 371-5986
Mailing address
1205 W MAIN ST, COLLINSVILLE, OK 74021-3114
(918) 371-5885
(918) 371-5986
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2098
OK
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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