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General NPI Number Information
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NPI Number | 1891773727
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Entity Type | Organization
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Legal Business Name | HEART AND MEDICAL CENTER INC
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 2701 W. UNIVERSITY BLVD.
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City | DURANT
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State | OK
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Zip | 74701-2997
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Country | US
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Telephone | 580-931-0500
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Fax | 580-920-8027
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Provider Business Mailing Address
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Address Line | 2701 W. UNIVERSITY BLVD.
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City | DURANT
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State | OK
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Zip | 74701-2997
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Country | US
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Telephone | 580-931-0500
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Fax | 580-920-8027
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIVEK KHETPAL
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Credential | MD
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Telephone | 580-931-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | K5131
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 20426
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License Number State | OK
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