| Organization Name: | ACCESS MEDICAL CATOOSA LLC |
| NPI Number: | 1255620902 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CANNEN R FERRELL (CEO) |
| Mailing Address: | 1875 N Highway 66 Catoosa |
| State: | OK US |
| Postal Code: | 740153071 |
| Phone Number: | 9187393600 |
| Fax Number: | 9187393610 |
| NPI Enumeration Date: | 04/04/2011 |
| NPI Last Update Date: | 08/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 9952 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |