South Moore Medical Clinic,pc

NPI #1972545218 in Moore, Oklahoma

Provider Information

NPI Number: 1972545218
Entity Type: Organization
Organization Name: South Moore Medical Clinic,pc
Primary Specialty: Family Medicine
Enumeration Date: Jun 12, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 14800 S WESTERN AVE
City: Moore
State: Oklahoma
ZIP Code: 73170-7112
Phone: (405) 912-4900

Authorized Official

Name: KEITH R. LAYNE, M.D.
Title: PHYSICIAN
Phone: (405) 912-4900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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