Provider Demographics
NPI:1669787552
Name:JUNE MEDICAL LLC
Entity type:Organization
Organization Name:JUNE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:HUME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-634-2929
Mailing Address - Street 1:3700 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3402
Mailing Address - Country:US
Mailing Address - Phone:405-634-2929
Mailing Address - Fax:405-634-5055
Practice Address - Street 1:3700 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3402
Practice Address - Country:US
Practice Address - Phone:405-634-2929
Practice Address - Fax:405-634-5055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4598207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty