Main Medical Clinic LLC
NPI #1710758966 in Tishomingo, Oklahoma
Provider Information
- NPI Number
- 1710758966
- Entity Type
- Organization
- Organization Name
- Main Medical Clinic LLC
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Jan 15, 2024
- Last Updated
- Jan 15, 2024
Practice Location
- Address
- 108 W MAIN ST
- City
- Tishomingo
- State
- Oklahoma
- ZIP Code
- 73460-1723
- Phone
- (580) 774-3548
Authorized Official
- Name
- SHARON MARSHALL
- Title
- OWNER
- Phone
- (817) 739-5848
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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