Organization
IMMEDIATE CARE OF OKLAHOMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PENWELL D.O. (PRESIDENT/COM)
(405) 600-6869
Entity
Organization
Contact information
Practice address
10616 U.S. HIGHWAY 66, SUITE 100, OKLAHOMA CITY, OK 73099
(405) 600-6869
Mailing address
PO BOX 720790, NORMAN, OK 73070-4614
(405) 600-6869
(405) 600-6978
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200459760
—
OK
Enumeration date
08/02/2019
Last updated
08/02/2019
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