| Family Wellness Center Of Norman Llc | |
|
2760 Washington Dr Ste 110 Norman OK 73069-1009 | |
| (405) 360-2827 | |
| (405) 283-1124 |
| Full Name | Family Wellness Center Of Norman Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2760 Washington Dr Ste 110, Norman, Oklahoma |
| Authorized Official Name and Position | Jimi Carman (OWNER) |
| Authorized Official Contact | 4053602827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Wellness Center Of Norman Llc 2760 Washington Dr Ste 110 Norman OK 73069-1009 Ph: (405) 360-2827 | Family Wellness Center Of Norman Llc 2760 Washington Dr Ste 110 Norman OK 73069-1009 Ph: (405) 360-2827 |
| NPI Number | 1013539774 |
|---|---|
| Provider Enumeration Date | 05/15/2020 |
| Last Update Date | 05/15/2020 |
| Certification Date | 05/15/2020 |
| Medicare PECOS PAC ID | 3375935588 |
|---|---|
| Medicare Enrollment ID | O20220120002340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013539774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Susan M Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992770853 PECOS PAC ID: 0840197836 Enrollment ID: I20031217000787 |
| Provider Name | Jack K Gray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295708519 PECOS PAC ID: 8325113145 Enrollment ID: I20080813000606 |
| Provider Name | Paula J Rother |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780184754 PECOS PAC ID: 2567719925 Enrollment ID: I20180717003151 |
| Provider Name | Teresa L Sherman |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1174155691 PECOS PAC ID: 8527450741 Enrollment ID: I20220121000098 |
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