MEDICARE: OKLAHOMA HMA URGENT 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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1861618720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OKLAHOMA HMA URGENT CARE, LLC

Provider Business Mailing Address
First Line	:	5811 PELICAN BAY BLVD
Second Line	:	SUITE 500
City	:	NAPLES
State	:	FL
Zip	:	34108-2704
Country	:	US
Telephone Number	:	239-598-3131
Fax Number	:	239-598-9433

Provider Business Practice Location Address
First Line	:	2801 S DOUGLAS BLVD
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-7123
Country	:	US
Telephone Number	:	405-737-3278
Fax Number	:

Authorized Official
Title or Position	:	SR VICE PRESIDENT
Name	:	MR. STANLEY D MCLEMORE
Credential	:
Telephone Number	:	239-598-3131

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	09/08/2009

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