Healthcare Provider Details

I. General information

NPI: 1881756740
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF CUSHING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 E CHERRY ST
CUSHING OK
74023-4102
US

IV. Provider business mailing address

1030 E CHERRY ST
CUSHING OK
74023-4102
US

V. Phone/Fax

Practice location:
  • Phone: 918-225-0616
  • Fax: 918-225-3740
Mailing address:
  • Phone: 918-225-0616
  • Fax: 918-225-3740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: KAREN E OESTMANN
Title or Position: OFFICE MANAGER
Credential:
Phone: 918-225-0616