Organization
HINTON FAMILY MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GALE GARNER PA-C (MANAGING MEMBER)
(405) 542-6131
Entity
Organization
Contact information
Practice address
1500 N BROADWAY BLVD, HINTON, OK 73047-0220
(405) 542-6131
(405) 542-3665
Mailing address
PO BOX 220, 1500 N BROADWAY BVLD, HINTON, OK 73047-0220
(405) 542-6131
(405) 542-3665
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14812
OK
363A00000X
Physician Assistant
Primary
PA 873
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200073360A
—
OK
Enumeration date
10/17/2006
Last updated
09/09/2010
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