Windsor Park Medical Clinic
NPI #1104070259 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1104070259
- Entity Type
- Organization
- Organization Name
- Windsor Park Medical Clinic
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Nov 14, 2008
- Last Updated
- Nov 14, 2008
Practice Location
- Address
- 2512 N MERIDIAN AVE
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73107-1035
- Phone
- (405) 605-5415
Authorized Official
- Name
- STACY LOUISE FAGAN, P.A.C.
- Title
- PHYSICIAN ASSISTANT
- Phone
- (405) 605-5415
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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