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General NPI Number Information
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NPI Number | 1033129333
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Entity Type | Organization
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Legal Business Name | PUTNAM NORTH FAMILY MEDICAL CENTER, INC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11220 N ROCKWELL AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73162-2725
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Country | US
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Telephone | 405-722-9474
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Fax | 405-722-9463
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Provider Business Mailing Address
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Address Line | 11220 N ROCKWELL AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73162-2725
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Country | US
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Telephone | 405-722-9474
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Fax | 405-722-9463
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN R PITTMAN
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Credential | MD
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Telephone | 405-722-9474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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