Clay Warren, | |
1001 N Country Club Rd, Ada, OK 74820-2847 | |
(580) 421-4570 | |
(580) 421-6283 |
Full Name | Clay Warren |
---|---|
Gender | Male |
Speciality | Physical Medicine & Rehabilitation |
Location | 1001 N Country Club Rd, Ada, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023198165 | NPI | - | NPPES |
PT3927 | Other | OK | OK LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208100000X | Physical Medicine & Rehabilitation | PT3927 (Oklahoma) | Primary |
Entity Name | Summit Rehab Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447480082 PECOS PAC ID: 4486794591 Enrollment ID: O20091222000314 |
Mailing Address | Practice Location Address |
---|---|
Clay Warren, 1001 N Country Club Rd, Ada, OK 74820-2847 Ph: (580) 421-4570 | Clay Warren, 1001 N Country Club Rd, Ada, OK 74820-2847 Ph: (580) 421-4570 |
Jackie Mcdaniel, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1001 N Country Club Rd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-421-6283 | |
Lesli Barrett, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1001 N Country Club Rd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-436-2675 | |
Jamie Mose, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1001 N Country Club Rd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-421-6283 | |
Britt Johnson, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1001 N Country Club Rd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-421-6283 |