| |
2426 W Owen K Garriott Rd, Enid, OK 73703-5221 | |
(580) 233-7600 | |
(580) 233-7661 |
Full Name | |
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Type | Facility |
Speciality | Family Medicine |
Location | 2426 W Owen K Garriott Rd, Enid, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437378478 | NPI | - | NPPES |
100215980C | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
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171100000X | Acupuncturist | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Bobby Kang |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538364005 PECOS PAC ID: 8426090606 Enrollment ID: I20050531000035 |
Provider Name | David Kang |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205276136 PECOS PAC ID: 3678863842 Enrollment ID: I20231117000037 |
Mailing Address | Practice Location Address |
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2426 W Owen K Garriott Rd, Enid, OK 73703-5221 Ph: (580) 233-7600 | 2426 W Owen K Garriott Rd, Enid, OK 73703-5221 Ph: (580) 233-7600 |