Provider Demographics
NPI:1427604719
Name:MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC
Entity Type:Organization
Organization Name:MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC
Other - Org Name:MCCURTAIN MEMORIAL SURGICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KENA
Authorized Official - Middle Name:CHEREE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-208-3103
Mailing Address - Street 1:1301 E LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-7300
Mailing Address - Country:US
Mailing Address - Phone:580-286-7623
Mailing Address - Fax:
Practice Address - Street 1:1425 E LINCOLN RD STE B3
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-7345
Practice Address - Country:US
Practice Address - Phone:580-286-2947
Practice Address - Fax:580-286-8287
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-13
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health