Organization
EASTPOINTE MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ROXANN SHAW (PRESIDENT)
(903) 495-1105
Entity
Organization
Contact information
Practice address
1506 S BROADWAY ST, POTEAU, OK 74953-2900
(903) 495-1105
Mailing address
1506 S BROADWAY ST, POTEAU, OK 74953-2900
(918) 647-7046
(918) 647-7047
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200633990A
—
OK
Enumeration date
10/27/2015
Last updated
02/06/2017
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