Organization
MAIN MEDICAL CLINIC LLC
Active
Other names
Main Street Medical
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON MARSHALL (OWNER)
(817) 739-5848
Entity
Organization
Contact information
Practice address
108 W MAIN ST, TISHOMINGO, OK 73460-1723
(580) 774-3548
Mailing address
108 W MAIN ST, TISHOMINGO, OK 73460-1723
(580) 774-3548
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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