| Midway Medical Clinic | |
|
351 N Air Depot Blvd Suite Bb Midwest City OK 73110-1700 | |
| (405) 610-3600 | |
| (405) 610-3607 |
| Full Name | Midway Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 351 N Air Depot Blvd, Midwest City, Oklahoma |
| Authorized Official Name and Position | Mckinley Boatner (CEO) |
| Authorized Official Contact | 4056103600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midway Medical Clinic Po Box 30739 Midwest City OK 73140 Ph: (405) 610-3600 | Midway Medical Clinic 351 N Air Depot Blvd Suite Bb Midwest City OK 73110-1700 Ph: (405) 610-3600 |
| NPI Number | 1144307554 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 07/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144307554 | NPI | - | NPPES |
| 200015390A | Medicaid | OK | |
| 200015390B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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