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Organization

PHYSICIAN PREFERRED MEDICAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH RYAN ORTON (MANAGING MEMBER)
(405) 206-1313
Entity
Organization

Contact information

Practice address
3300 NW 56TH ST, 101, OKLAHOMA CITY, OK 73112-4538
(855) 203-0681
(405) 213-1554
Mailing address
3300 NW 56TH ST, SUITE 101, OKLAHOMA CITY, OK 73112-4538
(855) 203-0681
(405) 213-1554

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200497520A
OK
Enumeration date
09/18/2012
Last updated
09/20/2016
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