Organization
PREMISE HEALTH OF OKLAHOMA MEDICAL, P.C
Active
Other names
Goodyear Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
901 SW GOODYEAR BLVD, LAWTON, OK 73505-9755
(580) 510-6361
(580) 531-5779
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/09/2006
Last updated
10/13/2022
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