East Lawton Neighborhood Family Clinic PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EAST LAWTON NEIGHBORHOOD FAMILY CLINIC PLLC

Practice address

1102 SE 36TH St
Lawton, OK 73501-8462

Phone

(580) 695-1057

NPI assigned

Jun 26, 2014

Last updated

Jun 26, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Frank Williams, PAC

Title

Owner

Phone

(580) 695-1057

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• East Lawton Neighborhood Family Clinic, PLLC

  • Primary Care Clinic/Center
  • Lawton, OK
  • NPI 1720480080
  NPPES parent name

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1730594987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 SE 36TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735018462",
            "telephone_number": "580-695-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SE 36TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735018462",
            "telephone_number": "580-695-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LAWTON NEIGHBORHOOD FAMILY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-695-1057",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Rose Dyer
• Shane Michael Dyer
• Valkethea Dyette
• Kristy Eaddy
• Amanda L Eary, PHARM.D
• East Lawton Neighborhood Family Clinic, PLLC
• Michelle East
• Eastside Clinic Pharmacy (Eastside Pharmacy)
• Eastside Clinic Pharmacy (Eastside Pharmacy LTC)
• Rachel Eberhardt

• Family Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.