Provider Demographics
NPI:1205004074
Name:ALAN R. MCKOWN, DC, PC
Entity Type:Organization
Organization Name:ALAN R. MCKOWN, DC, PC
Other - Org Name:MCKOWN FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKOWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-226-7181
Mailing Address - Street 1:PO BOX 2371
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73402-2371
Mailing Address - Country:US
Mailing Address - Phone:580-226-7181
Mailing Address - Fax:580-226-7192
Practice Address - Street 1:804 16TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1818
Practice Address - Country:US
Practice Address - Phone:580-226-7181
Practice Address - Fax:580-226-7192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2618261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU31237Medicare UPIN