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Organization

ABC MEDICAL CLINIC, INC PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LINDA L HEINZE (OFFICE MANAGER)
(580) 889-3355
Entity
Organization

Contact information

Practice address
1510 S VIRGINIA AVE, ATOKA, OK 74525-3246
(580) 889-3355
(580) 927-9941
Mailing address
PO BOX 568, ATOKA, OK 74525-0568
(580) 889-3355
(580) 889-5272

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2096
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100747790C
OK
Enumeration date
07/30/2007
Last updated
05/09/2013
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