Provider Demographics
NPI:1245632264
Name:TODAY CLINIC WEST
Entity type:Organization
Organization Name:TODAY CLINIC WEST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUTHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-740-1968
Mailing Address - Street 1:701 NE 36TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-7203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1145 N MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-5095
Practice Address - Country:US
Practice Address - Phone:405-631-0611
Practice Address - Fax:405-631-0811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TODAY CLINIC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty