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General NPI Number Information
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NPI Number | 1952477093
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Entity Type | Organization
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Legal Business Name | URGENT CARE CLINIC OF ATOKA, PC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 1510 S. VIRGINIA AVE
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City | ATOKA
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State | OK
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Zip | 74525-3246
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Country | US
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Telephone | 580-889-6621
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Fax | 580-889-3602
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Provider Business Mailing Address
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Address Line | 1510 S. VIRGINIA AVE
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City | ATOKA
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State | OK
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Zip | 74525-3246
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Country | US
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Telephone | 580-889-6621
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Fax | 580-889-3602
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. NOEL W EMERSON
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Credential | DO
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Telephone | 580-889-6621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 1806
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3521
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License Number State | OK
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