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General NPI Number Information
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NPI Number | 1962061697
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Entity Type | Organization
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Legal Business Name | MIDTOWN MEDICAL LLC
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 2342 N INTERSTATE DR
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City | NORMAN
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State | OK
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Zip | 73072-2991
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Country | US
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Telephone | 405-942-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 2342 N INTERSTATE DR
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City | NORMAN
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State | OK
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Zip | 73072-2991
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Country | US
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Telephone | 405-203-4324
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Fax |
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Authorized Official
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Title or Position | OWNER, DIRECTOR OF OPERATIONS
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Name | MELINDA ANN STURGESS-STREICH
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Credential |
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Telephone | 405-203-4324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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