Provider Demographics
NPI:1316054232
Name:NEWMAN PHYSICIANS' GROUP, INC.
Entity type:Organization
Organization Name:NEWMAN PHYSICIANS' GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAUBHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-938-5276
Mailing Address - Street 1:PO BOX 703
Mailing Address - Street 2:
Mailing Address - City:SHATTUCK
Mailing Address - State:OK
Mailing Address - Zip Code:73858-0703
Mailing Address - Country:US
Mailing Address - Phone:580-938-5275
Mailing Address - Fax:580-938-2256
Practice Address - Street 1:905 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SHATTUCK
Practice Address - State:OK
Practice Address - Zip Code:73858-9205
Practice Address - Country:US
Practice Address - Phone:580-938-5275
Practice Address - Fax:580-938-2256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100730710AMedicaid
OK0659070001Medicare NSC
OK100730710AMedicaid