Provider Demographics
NPI:1962061697
Name:MIDTOWN MEDICAL LLC
Entity type:Organization
Organization Name:MIDTOWN MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STURGESS-STREICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-203-4324
Mailing Address - Street 1:2342 N INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2991
Mailing Address - Country:US
Mailing Address - Phone:405-203-4324
Mailing Address - Fax:
Practice Address - Street 1:2342 N INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2991
Practice Address - Country:US
Practice Address - Phone:405-942-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care