Kickapoo Tribal Health Center is a medicare enrolled dental clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Mcloud, Oklahoma. The current practice location for Kickapoo Tribal Health Center is 105365 S. Hwy 102, Building M, Mcloud, Oklahoma. For appointments, you can reach them via phone at
(405) 964-2081. The mailing address for Kickapoo Tribal Health Center is Po Box 1360, Mcloud, Oklahoma and phone number is (405) 964-2081.
Kickapoo Tribal Health Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1265518203. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(405) 964-2081.
Dental Care Clinic Profile
| Full Name | Kickapoo Tribal Health Center |
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| Speciality | Clinic/Center |
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| Location | 105365 S. Hwy 102, Mcloud, Oklahoma |
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| Authorized Official Name and Position | Janetta Mahtapene (HEALTH DIRECTOR) |
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| Authorized Official Contact | 4059642081 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kickapoo Tribal Health Center
Po Box 1360
Mcloud
OK 74851-1360
Ph: (405) 964-2081 | Kickapoo Tribal Health Center
105365 S. Hwy 102
Building M
Mcloud
OK 74851
Ph: (405) 964-2081 |
NPI Details:
| NPI Number | 1265518203 |
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| Provider Enumeration Date | 10/31/2006 |
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| Last Update Date | 11/02/2011 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 6800706037 |
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| Medicare Enrollment ID | O20080523000213 |
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Medical Identifiers
Medical identifiers for Kickapoo Tribal Health Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1265518203 | NPI | - | NPPES |
| 100700140A | Medicaid | OK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| 261QR0200X | Clinic/center - Radiology | (* (Not Available)) | Secondary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Secondary |
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