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Organization

BARACON, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STAFFORD AUSTIN CONWAY JR. M.D. (NEUROLOGIST)
(580) 931-9250
Entity
Organization

Contact information

Practice address
626 BRYAN DR, DURANT, OK 74701-3462
(580) 931-9250
(580) 931-4810
Mailing address
626 BRYAN DR, DURANT, OK 74701-3462
(580) 931-9250
(580) 931-4810

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OK

Other

Enumeration date
08/08/2010
Last updated
07/21/2022
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