| Oklahoma Integrated Care Plc | |
|
1013 15th Ave Nw Ardmore OK 73401-1810 | |
| (580) 504-1517 | |
| Not Available |
| Full Name | Oklahoma Integrated Care Plc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1013 15th Ave Nw, Ardmore, Oklahoma |
| Authorized Official Name and Position | Tasha Preston (NURSE PRACTITIONER) |
| Authorized Official Contact | 5805041517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oklahoma Integrated Care Plc 1013 15th Ave Nw Ardmore OK 73401-1810 Ph: (580) 238-4277 | Oklahoma Integrated Care Plc 1013 15th Ave Nw Ardmore OK 73401-1810 Ph: (580) 504-1517 |
| NPI Number | 1316540495 |
|---|---|
| Provider Enumeration Date | 11/19/2020 |
| Last Update Date | 07/30/2024 |
| Certification Date | 07/30/2024 |
| Medicare PECOS PAC ID | 5193113751 |
|---|---|
| Medicare Enrollment ID | O20211101001490 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316540495 | NPI | - | NPPES |
| Provider Name | Mary Jean Stuard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558731661 PECOS PAC ID: 5698075927 Enrollment ID: I20151118001671 |
| Provider Name | Tasha Preston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811205925 PECOS PAC ID: 8123258530 Enrollment ID: I20180906000303 |
| Provider Name | Stephanie D Sampson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366938391 PECOS PAC ID: 6901140599 Enrollment ID: I20181210000478 |
| Provider Name | April D Claxton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821731084 PECOS PAC ID: 9335185701 Enrollment ID: I20220518003004 |
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