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NPI Code Detail

MEDICARE: PUTNAM NORTH FAMILY MEDICAL CENTER, INC

MEDICARE: PUTNAM NORTH FAMILY MEDICAL CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1033129333
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUTNAM NORTH FAMILY MEDICAL CENTER, INC
Provider Business Mailing Address
First Line : 11220 N ROCKWELL AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-2725
Country : US
Telephone Number : 405-722-9474
Fax Number : 405-722-9463
Provider Business Practice Location Address
First Line : 11220 N ROCKWELL AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-2725
Country : US
Telephone Number : 405-722-9474
Fax Number : 405-722-9463
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN R PITTMAN
Credential : MD
Telephone Number : 405-722-9474
Provider Enumeration Date : 08/09/2006
Last Update Date : 08/22/2020

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1861509838 — MS. ANGELA D. GRIMMETT ARNP
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Directions to “PUTNAM NORTH FAMILY MEDICAL CENTER, INC ” Practice Location

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