Provider Demographics
NPI:1881243012
Name:OUR FAMILY CLINIC
Entity type:Organization
Organization Name:OUR FAMILY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:CAROLINE
Authorized Official - Last Name:NWOKOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-826-1210
Mailing Address - Street 1:1515 N CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6611
Mailing Address - Country:US
Mailing Address - Phone:405-232-1090
Mailing Address - Fax:
Practice Address - Street 1:1515 N CLASSEN BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6611
Practice Address - Country:US
Practice Address - Phone:405-232-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1194204180OtherAPRN