Organization
MEDCOLOGY LLC
Active
Other names
Boulevard Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. T DENISE CATO (OWNER ADMINISTRATOR)
(405) 470-1884
Entity
Organization
Contact information
Practice address
3431 S BOULEVARD ST, SUITE 109, EDMOND, OK 73013-5475
(405) 562-1870
(405) 562-1871
Mailing address
PO BOX 22656, OKLAHOMA CITY, OK 73123-1656
(405) 470-1884
(405) 470-1028
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2006
Last updated
03/14/2011
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