NPIMap

Organization Active NPI

East Lawton Neighborhood Family Clinic, PLLC

  • Primary Care Clinic/Center
  • Lawton, OK
National Provider Identifier
1720480080
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
PA674 Issued in OK
Legal business name
EAST LAWTON NEIGHBORHOOD FAMILY CLINIC, PLLC
Practice address
1102 SE 36TH St
Ste. B
Lawton, OK 73501-8462
Phone
(580) 280-4644
Fax
(580) 280-4646
NPI assigned
Sep 18, 2014
Last updated
Sep 18, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST LAWTON NEIGHBORHOOD FAMILY CLINIC, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Frank Russel Williams Sr., PA-C
Title
Managing Partner
Phone
(580) 280-4644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X PA674 OK Primary

Addresses

Primary practice location

1102 SE 36TH St
Ste. B
Lawton, OK 73501-8462

Mailing address

1102 SE 36TH St
Ste. B
Lawton, OK 73501-8462
Phone (580) 280-4644

National Provider Directory

National Provider Directory
Part of
East Lawton Neighborhood Family Clinic PLLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1720480080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 SE 36TH ST",
            "address_2": "STE. B",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735018462",
            "telephone_number": "580-280-4644",
            "fax_number": "580-280-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SE 36TH ST",
            "address_2": "STE. B",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735018462",
            "telephone_number": "580-280-4644",
            "fax_number": "580-280-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LAWTON NEIGHBORHOOD FAMILY CLINIC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST LAWTON NEIGHBORHOOD FAMILY CLINIC, PLLC",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "RUSSEL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "580-280-4644",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": "PA674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.