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RESTORE FAMILY MEDICAL CLINIC II NPI 1194405308


NPI Information

NPI: 1194405308
Provider Name: RESTORE FAMILY MEDICAL CLINIC II

Doing Business As: RESTORE FAMILY MEDICAL CLINIC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 37D2289837

Address:
111 N 3RD ST
HUGO, OK
ZIP 74743
Phone: (580) 982-6044
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RESTORE FAMILY MEDICAL CLINIC II is a family nurse practitioner in Hugo, OK. RESTORE FAMILY MEDICAL CLINIC II NPI is 1194405308. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Restore Family Medical Clinic.

The provider's business location address is:

111 N 3RD ST
HUGO, OK
ZIP 74743-001
Phone: (580) 982-6044

The provider's authorized official is Kendall M Phillips .
The authorized official title is Owner/operator and has the following contact phone number (580) 982-6044.

The CLIA number assigned to this NPI record is 37D2289837 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/21/2023 and was last updated on 8/17/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.