Healthcare Provider Details

I. General information

NPI: 1689648008
Provider Name (Legal Business Name): THE MORRISON CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 W HIGHWAY 64
MORRISON OK
73061-9500
US

IV. Provider business mailing address

535 6TH ST
PAWNEE OK
74058-2542
US

V. Phone/Fax

Practice location:
  • Phone: 918-762-3942
  • Fax: 918-762-4675
Mailing address:
  • Phone: 918-762-3942
  • Fax: 918-762-4675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21798
License Number StateOK

VIII. Authorized Official

Name: GENE H EVANS
Title or Position: OWNER
Credential: M.D.
Phone: 918-762-3942