Loftin Family Practice

NPI 1295920734 - Clinic/Center - 261Q00000X

NPI Details
NPI 1295920734
Enumeration Date 09/07/2007
Last Updated 09/07/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name TERESA DIANE TERESA
Position OWNER
Phone (918) 456-3425
Fax (918) 456-3107
Practice Location
1323 W KEETOOWAH ST
TAHLEQUAH OK, 74464-3462, US
Phone (918) 456-3425
Fax (918) 456-3107
Business Location
1323 W KEETOOWAH ST
TAHLEQUAH OK, 74464-3462, US
Phone (918) 456-3425
Fax (918) 456-3107
Toxanomy
Taxonomy Code 261Q00000X
License State Oklahoma
License Number 22820
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According to our database, Loftin Family Practice NPI is 1295920734, taxonomy code is 261Q00000X and license number is 22820, license state is located at Oklahoma. Loftin Family Practice physically located at 1323 W Keetoowah St, Tahlequah OK, 74464-3462. NPI Number 1033115704 has the healthcare provider type.

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1295920734 NPI number is provided on an as is basis without warranty of any kind. 1295920734 is maintained by the National Plan & Provider Enumeration System. The contents of Loftin Family Practice are for informational purposes only.