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NPI Code Detail

MEDICARE: PROXIMITY HEALTH CARE LLC

MEDICARE: PROXIMITY HEALTH CARE LLC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1548787245
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROXIMITY HEALTH CARE LLC
Provider Business Mailing Address
First Line : 1415 N WATTS
Second Line :
City : SAYRE
State : OK
Zip : 73662-1310
Country : US
Telephone Number : 580-928-2044
Fax Number :
Provider Business Practice Location Address
First Line : 1415 N WATTS
Second Line :
City : SAYRE
State : OK
Zip : 73662-1310
Country : US
Telephone Number : 580-928-2044
Fax Number :
Authorized Official
Title or Position : OWNER
Name : STEPHANIE ROBISON
Credential : APRN-CNP
Telephone Number : 580-928-2044
Provider Enumeration Date : 08/24/2017
Last Update Date : 07/21/2022

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Directions to “PROXIMITY HEALTH CARE LLC ” Practice Location

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