| Ageless Family Medicine Llc | |
|
5300 N Meridian Ave Ste 8 Oklahoma City OK 73112-2137 | |
| (405) 768-2121 | |
| (405) 768-2232 |
| Full Name | Ageless Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5300 N Meridian Ave Ste 8, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Melanie Taponno (PROVIDER) |
| Authorized Official Contact | 4055124881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ageless Family Medicine Llc 1833 Olde School Rd Edmond OK 73012-3244 Ph: (405) 512-4881 | Ageless Family Medicine Llc 5300 N Meridian Ave Ste 8 Oklahoma City OK 73112-2137 Ph: (405) 768-2121 |
| NPI Number | 1710692470 |
|---|---|
| Provider Enumeration Date | 01/17/2023 |
| Last Update Date | 01/17/2023 |
| Medicare PECOS PAC ID | 0042655375 |
|---|---|
| Medicare Enrollment ID | O20240227001211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710692470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Yombi Melanie Ngouanyo Taponno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588101596 PECOS PAC ID: 4789960311 Enrollment ID: I20170417000452 |
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