| Organization Name: | KEYS FAMILY HEALTH CLINIC |
| NPI Number: | 1144461518 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN EUGENE COOKSON (NURSE PRACTITIONER/OWNER) |
| Mailing Address: | 26251 Hwy 82 Suite 1 Park Hill |
| State: | OK US |
| Postal Code: | 74451 |
| Phone Number: | 9182070667 |
| Fax Number: | 9182070683 |
| NPI Enumeration Date: | 03/16/2009 |
| NPI Last Update Date: | 10/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R0068390 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |