Individual
NATHAN KEITH MEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 MEDICAL PKWY, CLAREMORE, OK 74017-1088
(844) 458-2100
Mailing address
124 E 5TH ST, CLAREMORE, OK 74017-7411
(918) 504-4718
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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