Healthcare Provider Details

I. General information

NPI: 1255297628
Provider Name (Legal Business Name): HEARTLAND FAMILY PRACTICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 S 30TH ST
CLINTON OK
73601-3632
US

IV. Provider business mailing address

517 S 30TH ST
CLINTON OK
73601-3632
US

V. Phone/Fax

Practice location:
  • Phone: 580-331-3775
  • Fax: 580-547-4913
Mailing address:
  • Phone: 580-331-3775
  • Fax: 580-547-4913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY D MORRIS
Title or Position: NURSE PRACTITIONER
Credential: APRN
Phone: 580-331-3775