| Phoenix Gate Inc | |
|
211 E Court St Ste 6 Atoka OK 74525-2000 | |
| (580) 364-0700 | |
| (580) 364-0701 |
| Full Name | Phoenix Gate Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 211 E Court St Ste 6, Atoka, Oklahoma |
| Authorized Official Name and Position | John E Eckenberger (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5803640700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Gate Inc 211 E Court St Ste 6 Atoka OK 74525-2000 Ph: (580) 364-0700 | Phoenix Gate Inc 211 E Court St Ste 6 Atoka OK 74525-2000 Ph: (580) 364-0700 |
| NPI Number | 1639227028 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639227028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 256 (Oklahoma) | Primary |
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