EAST LAWTON NEIGHBORHOOD FAMILY CLINIC, PLLC (NPI# 1720480080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720480080 |
| Entity Type | Organization |
| Organization Name | EAST LAWTON NEIGHBORHOOD FAMILY CLINIC, PLLC |
| Practice Address |
1102 Se 36th St Ste. B Lawton OK 73501-8462 |
| Practice Telephone | 5802804644 |
| Practice Fax Number | 5802804646 |
| Mailing Telephone | 5802804644 |
| Mailing Fax Number | 5802804646 |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |
| Authorized Official Name | MR. FRANK RUSSEL WILLIAMS SR. (MANAGING PARTNER) |
| Authorized Official Telephone | 5802804644 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | Y |
| Parent Organization Name | EAST LAWTON NEIGHBORHOOD FAMILY CLINIC, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
PA674 | OK | Ambulatory Health Care Facilities |
| Street Address |
1102 SE 36TH ST STE. B |
| City | LAWTON |
| State | OK |
| Zip Code | 73501-8462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689670077 | Marshall Krizoa Nguessan | Audiologist | 1102 Se 36th St, Ste B, Lawton, OK 73501-8458 | 2005-06-22 |
| 1851839096 | Comanche County Hospital Authority | Clinic/Center | 1102 Se 36th St, Lawton, OK 73501-8462 | 2017-02-08 |
| 1730594987 | East Lawton Neighborhood Family Clinic Pllc | Family Medicine | 1102 Se 36th St, Lawton, OK 73501-8462 | 2014-06-26 |
| 1114126331 | Wendy S Bartanen Md, PC | Family Medicine | 1102 Se 36th St, Lawton, OK 73501-8462 | 2007-07-17 |
| 1790876316 | Joseph Brent Brennan | Pharmacist | 1102 Se 36th St, Suite A, Lawton, OK 73501-8462 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596729 | Alyssa K Manfredi | Speech-Language Pathologist | 1700 Nw Lee Blvd, Lawton, OK 73501 | 2020-10-21 |
| 1295079705 | Premier Behavorial Health | Community/Behavioral Health | 2305 Southwest H Avenue, Suite #1, Lawton, OK 73501 | 2012-11-21 |
| 1306156989 | Diana Nix | Licensed Practical Nurse | 611 Sw B Ave, Lawton, OK 73501 | 2010-10-15 |
| 1689993214 | Crystal Leday | Physical Therapy Assistant | 602 S.e. Wallock, Lawton, OK 73501 | 2010-05-21 |
| 1457679862 | Gary Dean Gardner | Dentist | 1301 West Gore Blvd, Suite 2, Lawton, OK 73501 | 2010-05-10 |
| 1962729848 | Tayler Gammon | Hearing Instrument Specialist | 423 S.w. C Ave, Lawton, OK 73501 | 2010-04-30 |
| 1932430725 | Eric B Carpenter Sr. | Counselor | 807 Sw F Avenue, Lawton, OK 73501 | 2010-01-19 |
| 1447487640 | Benjamin Llanos | Counselor | 1719 Sw 11th, Lawton, OK 73501 | 2009-06-15 |
| 1710122833 | Provide Hearing Aids | Public Health or Welfare | 1201 West Gore Blvd, Suite D, Lawton, OK 73501 | 2008-12-03 |
| 1053506121 | Mercer Beauty Supply | Orthotic Fitter | 1016 Sw D Ave, Lawton, OK 73501 | 2007-09-11 |
| Find all providers in zip 73501 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306210133 | Today Clinic Pllc | Clinic/Center | 4008 Nw Cache Rd, Lawton, OK 73505-3634 | 2015-11-17 |
| 1487833984 | Prompt Care, P.C. | Clinic/Center | 412 Sw Summit Ave, Lawton, OK 73501-5252 | 2007-10-31 |
| 1255344206 | Southwestern Emergency Department Physician Services, LLC | Clinic/Center | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476654 | Team Clinic Management Partners LLC | Clinic/Center | 372 N Cobb, Caney, OK 74533 | 2020-10-29 |
| 1184222705 | Essential Md, Pllc | Clinic/Center | 6316 E 102nd St Ste 100, Tulsa, OK 74137-7061 | 2020-10-15 |
| 1881292191 | Team Clinic Management Partners LLC | Clinic/Center | 3100 W New Orleans St, Broken Arrow, OK 74011-1468 | 2020-10-09 |
| 1972115392 | Team Clinic Management Partners LLC | Clinic/Center | 225 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-18 |
| 1093327413 | Team Clinic Management Partners LLC | Clinic/Center | 301 W New Orleans St, Broken Arrow, OK 74011-2206 | 2020-08-18 |
| 1962013110 | Team Clinic Management Partners LLC | Clinic/Center | 4300 E Gary Street, Broken Arrow, OK 74014 | 2020-08-12 |
| 1750992038 | Team Clinic Management Partners LLC | Clinic/Center | 251 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-11 |
| 1689285975 | Team Clinic Management Partners LLC | Clinic/Center | 301 E Tucson St, Broken Arrow, OK 74011-7235 | 2020-08-11 |
| 1417568700 | Team Clinic Management Partners LLC | Clinic/Center | 1351 E Albany St, Broken Arrow, OK 74012-8995 | 2020-08-11 |
| 1164033569 | Team Clinic Management Partners LLC | Clinic/Center | 6800 E Quincy Pl, Broken Arrow, OK 74014-4523 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.