| Jack D Norrell Lcsw Pc | |
|
6205 W Gore Blvd Lawton OK 73505-5836 | |
| (580) 536-3900 | |
| (580) 357-8787 |
| Full Name | Jack D Norrell Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 6205 W Gore Blvd, Lawton, Oklahoma |
| Authorized Official Name and Position | Ronda F Norrell (ADMINISTRATOR) |
| Authorized Official Contact | 5805363900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack D Norrell Lcsw Pc 6205 W Gore Blvd Lawton OK 73505-5836 Ph: (580) 536-3900 | Jack D Norrell Lcsw Pc 6205 W Gore Blvd Lawton OK 73505-5836 Ph: (580) 536-3900 |
| NPI Number | 1447553466 |
|---|---|
| Provider Enumeration Date | 12/14/2010 |
| Last Update Date | 12/14/2010 |
| Medicare PECOS PAC ID | 0749465441 |
|---|---|
| Medicare Enrollment ID | O20110422000107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447553466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2313 (Oklahoma) | Primary |
| Provider Name | Jack D Norrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467497438 PECOS PAC ID: 9133284771 Enrollment ID: I20090216000431 |
Lynch & Lynch, Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6205 W Gore Blvd, Lawton, OK 73505 Phone: 580-536-3900 Fax: 580-357-8787 | |
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