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General NPI Number Information
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NPI Number | 1407366784
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Entity Type | Organization
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Legal Business Name | FALLING WATER MEDICAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 2434 HARVILLE RD STE 100
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City | DUNCAN
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State | OK
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Zip | 73533-0100
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Country | US
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Telephone | 580-255-8564
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Fax | 580-255-8640
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Provider Business Mailing Address
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Address Line | 2434 HARVILLE RD STE 100
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City | DUNCAN
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State | OK
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Zip | 73533-0100
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Country | US
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Telephone | 580-255-8564
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Fax | 580-255-8640
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. FRANCIS JAMES MCGOURAN III
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Credential | MD
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Telephone | 580-255-8564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29349
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License Number State | OK
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