Provider Demographics
NPI:1073376604
Name:GARRISON EXEMPLAR COMPANY
Entity Type:Organization
Organization Name:GARRISON EXEMPLAR COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-517-6539
Mailing Address - Street 1:26 NW HEATHERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-9536
Mailing Address - Country:US
Mailing Address - Phone:405-517-6539
Mailing Address - Fax:
Practice Address - Street 1:4008 NW CACHE RD STE B
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3634
Practice Address - Country:US
Practice Address - Phone:405-517-6539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326467499OtherINDIVIDUAL NPI