Organization
PROMPT CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY CHARLES HICKMAN PHYSICIAN ASSISTANT (MANGER)
(580) 512-2780
Entity
Organization
Contact information
Practice address
4008 NW CACHE RD, LAWTON, OK 73505-3634
(580) 379-0200
(580) 699-8767
Mailing address
4008 NW CACHE RD, LAWTON, OK 73505-3634
(580) 379-0200
(580) 699-8767
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356390397
—
OK
05
—
1598999757
—
OK
Enumeration date
04/07/2020
Last updated
04/07/2020
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