Provider Demographics
NPI:1700618261
Name:MEDFIRST FAMILY CARE PLLC
Entity type:Organization
Organization Name:MEDFIRST FAMILY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-695-0101
Mailing Address - Street 1:614 NW ALLISON LN
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-0601
Mailing Address - Country:US
Mailing Address - Phone:580-695-0101
Mailing Address - Fax:580-357-8787
Practice Address - Street 1:2515 CHISHOLM TRAIL PKWY STE B
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-2675
Practice Address - Country:US
Practice Address - Phone:580-786-2051
Practice Address - Fax:580-470-7984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty