Organization Name: | PHOENIX MEDICAL CENTER |
NPI Number: | 1205208535 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KINYADA SINGLETON (MANAGING PARTNER) |
Mailing Address: | 557 Harrison St Pawnee |
State: | OK US |
Postal Code: | 740582566 |
Phone Number: | 9187625050 |
Fax Number: | 8775158550 |
NPI Enumeration Date: | 10/26/2015 |
NPI Last Update Date: | 10/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |