Organization
WALKUP FAMILY MEDICINE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STORMY WALKUP DO (OWNER)
(405) 639-7771
Entity
Organization
Contact information
Practice address
1302 S LYNN LN, IDABEL, OK 74745-6860
(405) 639-7771
Mailing address
1302 S LYNN LN, IDABEL, OK 74745-6860
(580) 286-3993
(580) 286-3967
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200730970A
—
OK
Enumeration date
12/03/2020
Last updated
01/10/2022
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