Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eagle Community Clinic LLC

Organization Family Medicine Physician · NPI 1063790202

Eagle Community Clinic LLC is a Family Medicine Physician in Edmond, Oklahoma. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

13800 Benson Rd 202
Edmond, OK 73013-6422
Phone: (405) 418-3077
Fax: (405) 418-3076
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1063790202
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationOklahoma Sports and Orthopedics Institute PLLC
Authorized official Brandon Penick — Director Of Reimbursement · (405) 360-6764
NPI enumeratedJuly 21, 2011
Last updated in NPPESJuly 21, 2011
Mailing addressPo Box 5995, Norman, OK 73070-5995

Other providers in Edmond