Organization
PONCA CITY IMMEDIATE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHADWICK ROSS DO (MEDICAL DIRECTOR)
(405) 317-7830
Entity
Organization
Contact information
Practice address
1201 E HARTFORD AVE, PONCA CITY, OK 74601-2018
(580) 762-1911
Mailing address
1201 E HARTFORD AVE, PONCA CITY, OK 74601-2018
(580) 762-1911
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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