Organization
KIAMICHI FAMILY MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GILBREATH (CEO)
(580) 241-5294
Entity
Organization
Contact information
Practice address
510 S PARK DR, BROKEN BOW, OK 74728-5330
(580) 241-5294
Mailing address
6026 BATTIEST PICKENS RD, BROKEN BOW, OK 74728-5033
(580) 241-5294
(580) 447-2908
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/24/2018
Last updated
04/26/2018
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