Organization
WILDHORSE FAMILY PRACTICE & URGENT CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA KAY SIMPSON OWNER (OWNER)
(918) 647-7829
Entity
Organization
Contact information
Practice address
3807 W CHEROKEE AVE, SALLISAW, OK 74955-2452
(918) 647-7829
(918) 654-3020
Mailing address
26256 CAUGHRON RD, CAMERON, OK 74932-2376
(918) 647-7829
(918) 654-3020
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1141
CLINIC
OK
Enumeration date
05/19/2014
Last updated
05/19/2014
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