Healthcare Provider Details

I. General information

NPI: 1215992235
Provider Name (Legal Business Name): URGENT CARE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 E LANSING ST
BROKEN ARROW OK
74012-2016
US

IV. Provider business mailing address

PO BOX 3500 DEPT 354
CLAREMORE OK
74018-3500
US

V. Phone/Fax

Practice location:
  • Phone: 918-258-9111
  • Fax: 918-251-9339
Mailing address:
  • Phone: 918-258-9111
  • Fax: 918-251-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3896
License Number StateOK

VIII. Authorized Official

Name: JONATHAN T HAMILTON
Title or Position: PRESIDENT/OWNER
Credential: DO
Phone: 918-258-9111