PREMISE HEALTH OF OKLAHOMA MEDICAL P.C NPI 1861972291

NPI Information

PREMISE HEALTH OF OKLAHOMA MEDICAL, P.C is a primary care clinic center in Broken Arrow, OK. PREMISE HEALTH OF OKLAHOMA MEDICAL, P.C NPI is 1861972291. The provider is registered as an organization entity type.
The provider Is Doing Business As Premise Health - Broken Arrow.

The provider's business location address is:

1104 E KENOSHA ST
BROKEN ARROW, OK
ZIP 74012-067
Phone: (918) 994-6866
Fax: (918) 994-6897

The provider's authorized official is Jonathan Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The enumeration date for this NPI number is 8/15/2018 and was last updated on 10/13/2022.

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:

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