Edmond Am Clinic LLC
Family Medicine in Edmond, OK. Organization (NPI-2).
NPI number1760655773
StatusActive
Last updated in NPPESOct 21, 2011
Details
- NPI
- 1760655773
- Entity type
- Organization (NPI-2)
- Legal business name
- Edmond Am Clinic LLC
- Organization subpart
- No
- Enumeration date
- Apr 10, 2008
- Last updated
- Oct 21, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | N/A | OK | Yes |
Other names
- Edmond Am Clinic (Doing Business As)
Practice location
1714 S Kelly AveEdmond, OK 73013-3624
Phone 405-216-3993 · Fax 405-216-3992
Mailing address
Po Box 269083Oklahoma City, OK 73126-9083
Phone 405-216-3993 · Fax 405-216-3992
Authorized official
Bill J Buffington
Medical Director
4052163993
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