Organization
FAIRFAX MEDICAL FACILITIES INC
Active
Other names
Robert Clark Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY LEEPER (CEO)
(918) 642-3100
Entity
Organization
Contact information
Practice address
212 N MAIN ST, FAIRFAX, OK 74637-3023
(918) 642-3100
(918) 642-5639
Mailing address
212 N MAIN ST, FAIRFAX, OK 74637-3023
(918) 642-3100
(918) 642-5639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200071420B
—
OK
05
—
200071420D
—
OK
05
—
200071420E
—
OK
05
—
200071420F
—
OK
05
—
200071420G
—
OK
Enumeration date
07/27/2006
Last updated
04/14/2026
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