Organization
TISHOMINGO DOCTOR'S MEDICAL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA RAGAN (DIRECTOR OF OPERATIONS)
(580) 371-9117
Entity
Organization
Contact information
Practice address
508 E 24TH ST, TISHOMINGO, OK 73460-3214
(580) 371-9117
(580) 371-3170
Mailing address
508 E 24TH ST, TISHOMINGO, OK 73460-3214
(580) 371-9117
(580) 371-3170
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/24/2009
Last updated
11/20/2009
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