Organization
PHYSICIANS URGENT CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD S. AGHA MD (PRESIDENT)
(580) 762-1911
Entity
Organization
Contact information
Practice address
1201 E. HARTFORD AVE, PONCA CITY, OK 74601-2018
(580) 762-1911
(580) 762-0887
Mailing address
1201 E. HARTFORD AVE, PONCA CITY, OK 74601-2018
(580) 762-1911
(580) 762-0887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100707120B
—
OK
05
—
100707120C
—
OK
01
—
CK2751
RAILROAD MEDICARE
OK
Enumeration date
08/20/2006
Last updated
09/22/2015
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