Provider Demographics
NPI:1891869822
Name:AQUILO HEALTH COMPANY P C DBA CANADIAN VALLEY FAMILY CARE
Entity Type:Organization
Organization Name:AQUILO HEALTH COMPANY P C DBA CANADIAN VALLEY FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-806-2200
Mailing Address - Street 1:1491 HEALTH CENTER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6767
Mailing Address - Country:US
Mailing Address - Phone:405-806-2200
Mailing Address - Fax:405-806-2207
Practice Address - Street 1:1491 HEALTH CENTER PARKWAY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6767
Practice Address - Country:US
Practice Address - Phone:405-806-2200
Practice Address - Fax:405-806-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200014470AMedicaid
OK200522016Medicare PIN
OK6343470001Medicare NSC