MCCURTAIN MEMORIAL MEDICAL MANAGEMENT INC NPI 1255583142

NPI Information

NPI: 1255583142
Provider Name: MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC

Doing Business As: MEDFAST WALK IN CLINIC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
1425 E LINCOLN RD
SUITE B-2
IDABEL, OK
ZIP 74745
Phone: (580) 286-4304
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MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC is a family nurse practitioner in Idabel, OK. MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC NPI is 1255583142. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Medfast Walk In Clinic.

The provider's business location address is:

1425 E LINCOLN RD
SUITE B-2
IDABEL, OK
ZIP 74745-345
Phone: (580) 286-4304
Fax: (580) 286-4305

The provider's authorized official is Ray B Whitmore .
The authorized official title is Chief Financial Officer and has the following contact phone number (580) 208-3104.

The enumeration date for this NPI number is 10/22/2008 and was last updated on 1/21/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	M37004801	MEDICARE PIN	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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