Organization
UNIVERSITY OF OKLAHOMA HEALTH SCIEN CTR SOUTHWEST OK FAMILY PRACTICE
Active
Other names
Southwest Oklahoma Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN MADDY (CHIEF EXECUTIVE OFFICER)
(405) 271-3932
Entity
Organization
Contact information
Practice address
1202 NW ARLINGTON AVE, LAWTON, OK 73507-6537
(580) 248-2288
(580) 248-5757
Mailing address
1202 NW ARLINGTON AVE, LAWTON, OK 73507-6537
(580) 248-2288
(580) 248-5757
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200021490C
—
OK
Enumeration date
08/27/2006
Last updated
05/02/2017
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