The Medical Clinic, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

28454 Issued in OK

Legal business name

THE MEDICAL CLINIC, INC

Practice address

1630 Santa Fe St.
Waynoka, OK 73860-0000

Phone

(580) 824-0330

Fax

(580) 824-0939

NPI assigned

Apr 1, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Susan M Hull, M.D.

Title

Owner

Phone

(580) 824-0330

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1790028496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 SANTA FE ST",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738600000",
            "telephone_number": "580-824-0330",
            "fax_number": "580-824-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 SANTA FE ST.",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738600000",
            "telephone_number": "580-824-0330",
            "fax_number": "580-824-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "HULL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-824-0330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": "28454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Leigh Ross
• Shonda Russell
• Jeffery S Schwerdtfeger, PA-C
• Lois Arleta Smith
• Bethany S Stout, LADC
• Patti Jo Vazquez, LCSWUNDER SUPERVISI
• Waynoka Mental Health Authority (Northwest Treatment Center)
• Waynoka Mental Health Authority (Northwest Substance Abuse Treatment Center)
• Waynoka Nursing Center Authority
• Shelly Marie Wingo

• Primary Care Clinic/Center in Waynoka, OK
• Providers in Waynoka, OK by specialty
• Primary Care Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.