Organization
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CASEY HAROLD ANSON (EXECUTIVE DIRECTOR)
(580) 925-3286
Entity
Organization
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-2362
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-2362
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100737160Q
—
OK
Enumeration date
05/28/2008
Last updated
01/31/2022
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