Fayetteville Vamc

NPI #1659607570 in Jay, Oklahoma

Provider Information

NPI Number: 1659607570
Entity Type: Organization
Organization Name: Fayetteville Vamc
Primary Specialty: Clinic/Center - VA
Enumeration Date: Oct 28, 2009
Last Updated: Sep 26, 2017

Practice Location

Address: 1569 N MAIN ST
City: Jay
State: Oklahoma
ZIP Code: 74346-2903
Phone: (615) 355-3451

Authorized Official

Name: ERIN POTTER
Title: NPI TEAM MEMBER
Phone: (202) 382-2579

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - VA — VA	261QV0200X	Primary

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