Organization
MIAMI WOMENS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIE LYNN KOEHLER DO (PHYSICIAN OWNER)
(918) 542-4300
Entity
Organization
Contact information
Practice address
310 SECOND AVE SW, SUITE 204, MIAMI, OK 74354
(918) 542-4300
(918) 542-3310
Mailing address
310 SECOND AVE SW, SUITE 204, MIAMI, OK 74354
(918) 542-4300
(918) 542-3310
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
03963
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200059700A
—
OK
Enumeration date
10/18/2006
Last updated
04/11/2011
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