4 R Families Medical Clinic Pllc | |
721 W Broadway Ave Ste C Enid OK 73701-3800 | |
(580) 297-5340 | |
Not Available |
Full Name | 4 R Families Medical Clinic Pllc |
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Speciality | Family Medicine |
Location | 721 W Broadway Ave Ste C, Enid, Oklahoma |
Authorized Official Name and Position | Margo Renee Short (OWNER) |
Authorized Official Contact | 5802975340 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
4 R Families Medical Clinic Pllc 721 W Broadway Ave Ste C Enid OK 73701-3800 Ph: (580) 297-5340 | 4 R Families Medical Clinic Pllc 721 W Broadway Ave Ste C Enid OK 73701-3800 Ph: (580) 297-5340 |
NPI Number | 1184135782 |
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Provider Enumeration Date | 10/23/2017 |
Last Update Date | 09/04/2024 |
Medicare PECOS PAC ID | 2961760111 |
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Medicare Enrollment ID | O20171218002156 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184135782 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 23498 (Oklahoma) | Primary |
Provider Name | Margo Renee Short |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1164478590 PECOS PAC ID: 7911910815 Enrollment ID: I20061005000658 |
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