Provider Demographics
NPI:1740615426
Name:A PLUS MINOR EMERGENCY WALK IN CLINIC
Entity type:Organization
Organization Name:A PLUS MINOR EMERGENCY WALK IN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:QUINN
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-318-0307
Mailing Address - Street 1:916 N MAIN
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-3118
Mailing Address - Country:US
Mailing Address - Phone:580-480-0033
Mailing Address - Fax:580-480-0044
Practice Address - Street 1:916 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-3118
Practice Address - Country:US
Practice Address - Phone:580-480-0033
Practice Address - Fax:580-480-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK3838261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care