| Beair Medical Group, Pllc | |
|
201 W. Main Street Suite 101 Jenks OK 74037 | |
| (918) 809-6952 | |
| Not Available |
| Full Name | Beair Medical Group, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 201 W. Main Street, Jenks, Oklahoma |
| Authorized Official Name and Position | Kara Marie Beair Butler (CEO/OWNER) |
| Authorized Official Contact | 9188096952 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beair Medical Group, Pllc 2209 W 117th St S Jenks OK 74037-4348 Ph: (918) 809-6952 | Beair Medical Group, Pllc 201 W. Main Street Suite 101 Jenks OK 74037 Ph: (918) 809-6952 |
| NPI Number | 1881170520 |
|---|---|
| Provider Enumeration Date | 07/16/2018 |
| Last Update Date | 07/16/2018 |
| Medicare PECOS PAC ID | 0840540878 |
|---|---|
| Medicare Enrollment ID | O20180912001370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881170520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1172 (Oklahoma) | Secondary |
| 207R00000X | Internal Medicine | 5195 (Oklahoma) | Primary |
| 208000000X | Pediatrics | 5195 (Oklahoma) | Secondary |
| Provider Name | Patti Wheaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669569000 PECOS PAC ID: 2769795004 Enrollment ID: I20150716000360 |
| Provider Name | Kara M Beair Butler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447541172 PECOS PAC ID: 2062645997 Enrollment ID: I20150930001233 |
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