Organization
LOGAN HOSPITAL AND MEDICAL CENTER AUTHORITY
Active
Other names
Center for Internal Medicine and Pediatrics - Crescent
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE ROWLEY (CEO)
(405) 260-4191
Entity
Organization
Contact information
Practice address
400 S GRAND, CRESCENT, OK 73028
(405) 969-2818
Mailing address
PO BOX 258, CRESCENT, OK 73028-0258
(405) 969-2818
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
2267
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD8588
RAILROAD MEDICARE
—
Enumeration date
07/13/2005
Last updated
11/15/2007
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