| Organization Name: | DOUGLAS MENZ, D.O. P.C. |
| NPI Number: | 1992996789 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE DOUGLAS MENZ (PHYSICIAN/OWNER) |
| Mailing Address: | 20912 Se 29th St Harrah |
| State: | OK US |
| Postal Code: | 730456439 |
| Phone Number: | 4053912970 |
| Fax Number: | 4053912972 |
| NPI Enumeration Date: | 08/06/2007 |
| NPI Last Update Date: | 08/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 3408 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |