Organization
SOUTHWARD FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREN SOUTHWARD M.D. (OWNER)
(580) 223-9008
Entity
Organization
Contact information
Practice address
1111 WALNUT DR, ARDMORE, OK 73401-2354
(580) 223-9008
(580) 223-9114
Mailing address
1111 WALNUT DR, ARDMORE, OK 73401-2354
(580) 223-9008
(580) 223-5051
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
21988
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442785229-001
—
OK
Enumeration date
08/28/2006
Last updated
03/04/2021
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