Provider Demographics
NPI:1023101110
Name:SULPHUR CLINIC INC.
Entity type:Organization
Organization Name:SULPHUR CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHESSER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:580-622-3344
Mailing Address - Street 1:921 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:OK
Mailing Address - Zip Code:73086-4459
Mailing Address - Country:US
Mailing Address - Phone:580-662-3344
Mailing Address - Fax:580-622-5572
Practice Address - Street 1:921 W 11TH ST
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:OK
Practice Address - Zip Code:73086-4459
Practice Address - Country:US
Practice Address - Phone:580-662-3344
Practice Address - Fax:580-622-5572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty