| Ou Physicians Latino Clinic | |
|
420 Sw 10 Okc OK 73160 | |
| (405) 232-4160 | |
| Not Available |
| Full Name | Ou Physicians Latino Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 420 Sw 10, Okc, Oklahoma |
| Authorized Official Name and Position | Brian Maddy (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4052711515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ou Physicians Latino Clinic 1122 Ne 13 Ori236 Okc OK 73117 Ph: (405) 271-1515 | Ou Physicians Latino Clinic 420 Sw 10 Okc OK 73160 Ph: (405) 232-4160 |
| NPI Number | 1497840904 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 05/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497840904 | NPI | - | NPPES |
| 100744720X | Medicaid | OK | |
| 200284890A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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