| Organization Name: | FAMILY CLINIC OF WELEETKA |
| NPI Number: | 1699953687 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAN PARKER (MANAGER) |
| Mailing Address: | 315 W. 9th Weleetka |
| State: | OK US |
| Postal Code: | 748800337 |
| Phone Number: | 4057862248 |
| Fax Number: | 4057862006 |
| NPI Enumeration Date: | 02/01/2008 |
| NPI Last Update Date: | 06/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 373819 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |