Organization Name: | MARLOW FAMILY HEALTHCARE PRESTON HEATH BOYLES SOLE MBR |
NPI Number: | 1750634762 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PRESTON HEATH BOYLES (OWNER) |
Mailing Address: | 311 W Main St Marlow |
State: | OK US |
Postal Code: | 730552441 |
Phone Number: | 5807564076 |
Fax Number: | 5807564077 |
NPI Enumeration Date: | 10/16/2012 |
NPI Last Update Date: | 02/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 82777 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |