Organization
INTERNAL MEDICINE ASSOCIATES OF PONCA CITY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELINDA R ALLEN DO (OWNER DO)
58076161778
Entity
Organization
Contact information
Practice address
100 ELMWOOD AVE, PONCA CITY, OK 74601-3406
(580) 716-1778
(580) 382-4157
Mailing address
100 ELMWOOD AVE, PONCA CITY, OK 74601-3406
(580) 716-1778
(580) 382-4157
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
3741
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200037370A
—
OK
Enumeration date
10/30/2006
Last updated
01/27/2016
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