Healthcare Provider Details

I. General information

NPI: 1033491121
Provider Name (Legal Business Name): PATRICK MCCUE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97TH MEDICAL GROUP, 301 N. FIRST ST
ALTUS AFB OK
53723
US

IV. Provider business mailing address

97TH MEDICAL GROUP, 301 N. FIRST ST
ALTUS AFB OK
53723
US

V. Phone/Fax

Practice location:
  • Phone: 580-481-5230
  • Fax:
Mailing address:
  • Phone: 580-481-5230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: