Organization
GREGORY MEDICAL CLINIC LLC
Active
Other names
dr. myra gregory do
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRA ANN GREGORY DO (OWNER/PHYSICIAN)
(918) 647-9533
Entity
Organization
Contact information
Practice address
2202 N BROADWAY ST, POTEAU, OK 74953-2000
(918) 647-9533
(918) 647-9492
Mailing address
2202 N BROADWAY ST, PO BOX 1368, POTEAU, OK 74953-2000
(918) 647-9533
(918) 647-9492
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3031
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100120120F
—
OK
Enumeration date
09/04/2009
Last updated
09/28/2009
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