Organization
LOCAL MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY LANCE GREGSTON MD (OWNER/PHYSICIAN)
(580) 875-5622
Entity
Organization
Contact information
Practice address
402 N BROADWAY ST, WALTERS, OK 73572
(580) 252-5100
(580) 252-5102
Mailing address
402 N BROADWAY ST, WALTERS, OK 73572-1230
(580) 875-5622
(580) 252-5102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OK
Other
Enumeration date
05/04/2018
Last updated
02/28/2019
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