Healthcare Provider Details

I. General information

NPI: 1003139155
Provider Name (Legal Business Name): RINGROSE CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 E OKLAHOMA AVE
GUTHRIE OK
73044-3315
US

IV. Provider business mailing address

PO BOX 10
GUTHRIE OK
73044-0010
US

V. Phone/Fax

Practice location:
  • Phone: 405-282-0232
  • Fax: 405-282-7109
Mailing address:
  • Phone: 405-282-0232
  • Fax: 405-282-7109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateOK

VIII. Authorized Official

Name: DR. ROBERT EDWARD RINGROSE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 405-282-0232