Provider Demographics
NPI:1235309774
Name:ENGLES CLINIC
Entity Type:Organization
Organization Name:ENGLES CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:LAWSON
Authorized Official - Last Name:ENGLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-644-5130
Mailing Address - Street 1:4221 S WESTERN AVE
Mailing Address - Street 2:SUITE 4035
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3447
Mailing Address - Country:US
Mailing Address - Phone:405-644-5130
Mailing Address - Fax:405-644-5131
Practice Address - Street 1:4221 S WESTERN AVE
Practice Address - Street 2:SUITE 4035
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3447
Practice Address - Country:US
Practice Address - Phone:405-644-5130
Practice Address - Fax:405-644-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty