Healthcare Provider Details

I. General information

NPI: 1760576417
Provider Name (Legal Business Name): CIMARRON URGENT CARE CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 E. MAIN STREET
CUSHING OK
74023
US

IV. Provider business mailing address

PO BOX 1326
CUSHING OK
74023
US

V. Phone/Fax

Practice location:
  • Phone: 918-225-6904
  • Fax:
Mailing address:
  • Phone: 918-225-6904
  • Fax:

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: DR. FRANK HUBBARD
Title or Position: CO-PROPRIETOR
Credential: D.O.
Phone: 918-225-6904