Organization Name: | FAIRFAX MEDICAL FACILITIES INC |
NPI Number: | 1851535785 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NEAL D MCCONAGHY (BOARD CHAIRMAN) |
Mailing Address: | 716 S Highway 77 Newkirk |
State: | OK US |
Postal Code: | 746477009 |
Phone Number: | 5803622555 |
Fax Number: | 5803622948 |
NPI Enumeration Date: | 04/22/2009 |
NPI Last Update Date: | 12/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |