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General NPI Number Information
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NPI Number | 1184838203
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Entity Type | Organization
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Legal Business Name | MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 1301 E LINCOLN ROAD
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City | IDABEL
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State | OK
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Zip | 74745-7300
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Country | US
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Telephone | 580-286-7623
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Fax | 580-208-3199
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Provider Business Mailing Address
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Address Line | 1301 E LINCOLN ROAD
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City | IDABEL
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State | OK
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Zip | 74745-7300
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Country | US
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Telephone | 580-286-7623
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Fax | 580-208-3199
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Authorized Official
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Title or Position | CFO
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Name | KENA CHEREE ALLEN
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Credential |
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Telephone | 580-208-3103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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