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institution
Black Oak Clinic Llc
Clinic/Center in Broken Bow, Oklahoma
NPI 1366954661

Black Oak Clinic Llc is a Clinic/Center based in Broken Bow, OK. Black Oak Clinic Llc practices in Broken Bow, OK. The NPI Number for Black Oak Clinic Llc is 1366954661 and holds a License No. (Oklahoma).

The current practice location address for Black Oak Clinic Llc is 110 W 1St St, Broken Bow, OK and can be reached out via phone at 580-584-3099 and via fax at 580-584-3097.

Location: 110 W 1St St, Broken Bow, OK, 74728-3902
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1366954661
Provider Name
Black Oak Clinic Llc
Credential
Provider Entity Type
Organization
Address
110 W 1St St, Broken Bow, OK, 74728-3902
Phone Number
580-584-3099
Fax Number
580-584-3097
Provider Enumeration Date
10/26/2017
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200740450A 05 OK
institution
Provider Business Practice Location Address Details
Address
110 W 1St St
City
Broken Bow
State
Oklahoma
Zip
74728
Phone Number
580-584-3099
Fax Number
580-584-3097
person
Provider Business Mailing Address Details
Address
110 W 1St St
City
Broken Bow
State
Oklahoma
Zip
74728
Phone Number
580-584-3099
Fax Number
580-584-3097
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
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Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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