Healthcare Provider Details

I. General information

NPI: 1366362386
Provider Name (Legal Business Name): MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E LINCOLN RD
IDABEL OK
74745-7300
US

IV. Provider business mailing address

1301 E LINCOLN RD
IDABEL OK
74745-7300
US

V. Phone/Fax

Practice location:
  • Phone: 580-286-2947
  • Fax:
Mailing address:
  • Phone: 580-286-7623
  • Fax: 580-208-3199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KENA CHEREE ALLEN
Title or Position: CFO
Credential:
Phone: 580-286-7623