Healthcare Provider Details

I. General information

NPI: 1831144468
Provider Name (Legal Business Name): NOBLE FAMILY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E MAGUIRE RD STE 4000
NOBLE OK
73068-9403
US

IV. Provider business mailing address

530 N MONTE VISTA ST
ADA OK
74820-4612
US

V. Phone/Fax

Practice location:
  • Phone: 405-872-9494
  • Fax: 405-872-9464
Mailing address:
  • Phone: 580-310-9510
  • Fax: 580-436-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20674
License Number StateOK

VIII. Authorized Official

Name: DR. CHRISTOPHER M MEYER
Title or Position: OWNER / PHYSICIAN
Credential: M.D.
Phone: 405-872-9494