| Organization Name: | WALTERS FAMILY CLINIC |
| NPI Number: | 1346428521 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GLORIA E VAUGHN (OFFICE MANAGER) |
| Mailing Address: | 102 N Broadway St Walters |
| State: | OK US |
| Postal Code: | 735721258 |
| Phone Number: | 5808753320 |
| Fax Number: | 5808753131 |
| NPI Enumeration Date: | 02/10/2008 |
| NPI Last Update Date: | 06/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 10340 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |