GRANITE FAMILY MEDICAL CLINIC – NPI #1396911830
Clinic/Center

GRANITE FAMILY MEDICAL CLINIC is an AHC clinic located in GRANITE, OK. NPPES has assigned the NPI number 1396911830 to GRANITE FAMILY MEDICAL CLINIC on May 05, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “GRANITE FAMILY MEDICAL CLINIC” is a dba name, the actual legal business name for this organization is N EVANS EINTERPRISES LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was previously updated about 16 years ago on Aug 25, 2010. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GRANITE FAMILY MEDICAL CLINIC below.

NPI Profile for
N EVANS EINTERPRISES LLC

NPI Number
1396911830
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
N EVANS EINTERPRISES LLC
Doing Business As (dba): GRANITE FAMILY MEDICAL CLINIC
Primary location
417 N. MAIN
GRANITE, OK 73547
Phone: (580) 535-4598 Fax: (580) 535-4725
Mailing address
417 NORTH MAIN
P.O. BOX 243
GRANITE, OK 73547-0243
Phone: (580) 535-4598 Fax: (580) 535-4725
Organization Subpart
No
Authorized Official
NICOLE EVANS
PRESIDENT
Phone: (580) 706-0113
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)		 OK
363A00000X
- Physician Assistant		 OK 802

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.