Organization
ULTIMATE DIRECT PRIMARY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREN SOUTHWARD MD (OWNER)
(580) 465-2283
Entity
Organization
Contact information
Practice address
1111 WALNUT DR, ARDMORE, OK 73401-2354
(580) 223-9008
Mailing address
1111 WALNUT DR, ARDMORE, OK 73401-2354
(580) 223-9008
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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