| Gregory Medical Clinic Llc | |
|
2202 N Broadway St Poteau OK 74953-2000 | |
| (918) 647-9533 | |
| (918) 647-9492 |
| Full Name | Gregory Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2202 N Broadway St, Poteau, Oklahoma |
| Authorized Official Name and Position | Myra Ann Gregory (OWNER/PHYSICIAN) |
| Authorized Official Contact | 9186479533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Medical Clinic Llc 2202 N Broadway St Po Box 1368 Poteau OK 74953-2000 Ph: (918) 647-9533 | Gregory Medical Clinic Llc 2202 N Broadway St Poteau OK 74953-2000 Ph: (918) 647-9533 |
| NPI Number | 1437482692 |
|---|---|
| Provider Enumeration Date | 09/04/2009 |
| Last Update Date | 09/28/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437482692 | NPI | - | NPPES |
| 100120120F | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3031 (Oklahoma) | Primary |
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