Premise Health of Oklahoma Medical, P.c
NPI #1861972291 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1861972291
- Entity Type
- Organization
- Organization Name
- Premise Health of Oklahoma Medical, P.c
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Aug 15, 2018
- Last Updated
- Oct 13, 2022
Practice Location
- Address
- 1104 E KENOSHA ST
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-2067
- Phone
- (918) 994-6866
Authorized Official
- Name
- DR. JONATHAN LEIZMAN, MD
- Title
- PRESIDENT
- Phone
- (216) 479-9063
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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