MEDICARE: DR. MONTY J GRUGAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4146	OK

General Provider Information

NPI Number	:	1316907397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONTY J GRUGAN DO

Provider Business Mailing Address
First Line	:	117 N BROADWAY ST
Second Line	:
City	:	BROKEN BOW
State	:	OK
Zip	:	74728-3933
Country	:	US
Telephone Number	:	580-208-3121
Fax Number	:	580-208-3193

Provider Business Practice Location Address
First Line	:	1301 E LINCOLN RD
Second Line	:
City	:	IDABEL
State	:	OK
Zip	:	74745-7300
Country	:	US
Telephone Number	:	580-208-3121
Fax Number	:	580-208-3193

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	12/30/2016

Similar Medicare Providers

1194727685 — DR. RAYMOND W SMITH MD
Practice Location Address:

1301 E LINCOLN RD
IDABEL, OK
74745-7300

Practice Phone: 580-208-3159
Practice Fax:

1255393476 — DR. STEPHEN JOHN KARMAN MD
Practice Location Address:

1301 E LINCOLN RD
IDABEL, OK
74745-7300

Practice Phone: 580-286-7623
Practice Fax: 580-208-3199

1700844313 — KELLY BACON
Practice Location Address:

1301 E LINCOLN RD
IDABEL, OK
74745-7300

Practice Phone: 580-286-7623
Practice Fax:

1629020177 — MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.
Practice Location Address:

1301 E LINCOLN RD
IDABEL, OK
74745-7300

Practice Phone: 580-208-3100
Practice Fax: 580-208-3199

1215980131 — NEON CLINIC, INC
Practice Location Address:

1301 LINCOLN RD
IDABEL, OK
74745-7300

Practice Phone: 580-208-3121
Practice Fax:

1285665836 — MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.
Practice Location Address:

1301 EAST LINCOLN ROAD
IDABEL, OK
74745-7300

Practice Phone: 580-208-3100
Practice Fax: 580-208-3199

Directions to “ DR. MONTY J GRUGAN DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.