| Aryan P. Kadivar, M.d., P.c. | |
|
1002 Sw 52nd St Lawton OK 73505-7840 | |
| (580) 248-2220 | |
| (580) 248-2208 |
| Full Name | Aryan P. Kadivar, M.d., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 1002 Sw 52nd St, Lawton, Oklahoma |
| Authorized Official Name and Position | Aryan Parker Kadivar (OWNER/PHYSICIAN) |
| Authorized Official Contact | 5806785860 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aryan P. Kadivar, M.d., P.c. 4525 Sw Atom Ave Lawton OK 73505-6823 Ph: (580) 357-6007 | Aryan P. Kadivar, M.d., P.c. 1002 Sw 52nd St Lawton OK 73505-7840 Ph: (580) 248-2220 |
| NPI Number | 1336259613 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 10/02/2007 |
| Medicare PECOS PAC ID | 7517962251 |
|---|---|
| Medicare Enrollment ID | O20061002000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336259613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Aryan Kadivar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578509170 PECOS PAC ID: 4981607561 Enrollment ID: I20061002000177 |
| Provider Name | Natalie S Hamblin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861689531 PECOS PAC ID: 8729167978 Enrollment ID: I20080430000091 |
| Provider Name | Amy Casey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053717546 PECOS PAC ID: 3678885738 Enrollment ID: I20150701001869 |
| Provider Name | Tonya Bardsher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932627387 PECOS PAC ID: 1658607650 Enrollment ID: I20190730000331 |
| Provider Name | Shawn Michael Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720637093 PECOS PAC ID: 8123452778 Enrollment ID: I20200107001959 |
| Provider Name | Autumn June Mckillip |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487326906 PECOS PAC ID: 3577959063 Enrollment ID: I20220411000074 |
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