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General NPI Number Information
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NPI Number | 1548459266
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Entity Type | Organization
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Legal Business Name | MEDICAL CLINIC OF MCALESTER, LLC
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 320 E DELAWARE AVE
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City | MCALESTER
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State | OK
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Zip | 74501-5512
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Country | US
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Telephone | 918-423-5916
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Fax | 918-423-5967
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Provider Business Mailing Address
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Address Line | PO BOX 1006
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City | MCALESTER
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State | OK
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Zip | 74502-1006
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Country | US
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Telephone | 918-423-5916
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Fax | 918-423-5967
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Authorized Official
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Title or Position | OWNER
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Name | DR. NELSON C ONARO
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Credential |
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Telephone | 918-423-5916
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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 | 3437
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License Number State | OK
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