Organization
PERRY MEMORIAL HOSPITAL AUTHORITY
Active
Other names
Community Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN FULLER (CHAIRMAN OF THE BOARD)
(580) 336-2176
Entity
Organization
Contact information
Practice address
501 N 14TH ST, PERRY, OK 73077-5021
(580) 336-2176
(580) 336-3178
Mailing address
1318 ELM ST, PERRY, OK 73077-5034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2268
OK
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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