| Providence Of Oklahom | |
|
134 N 12th Ave Durant OK 74701-4718 | |
| (580) 924-6363 | |
| (580) 924-0379 |
| Full Name | Providence Of Oklahom |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 134 N 12th Ave, Durant, Oklahoma |
| Authorized Official Name and Position | Breeann Marie Hoerning (AR AND BILLING MANAGER) |
| Authorized Official Contact | 5207476600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Of Oklahom 620 N Craycroft Rd Tucson AZ 85711-1448 Ph: (520) 747-6600 | Providence Of Oklahom 134 N 12th Ave Durant OK 74701-4718 Ph: (580) 924-6363 |
| NPI Number | 1407916802 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407916802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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