| August Fifth Llc | |
|
7711 E 111th St Ste 109 Tulsa OK 74133-2562 | |
| (918) 955-0000 | |
| Not Available |
| Full Name | August Fifth Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 7711 E 111th St Ste 109, Tulsa, Oklahoma |
| Authorized Official Name and Position | Patrick Vanschoyck (PHYSICIAN / OWNER) |
| Authorized Official Contact | 9189550000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| August Fifth Llc 7711 E 111th St Ste 109 Tulsa OK 74133-2562 Ph: () - | August Fifth Llc 7711 E 111th St Ste 109 Tulsa OK 74133-2562 Ph: (918) 955-0000 |
| NPI Number | 1477325249 |
|---|---|
| Provider Enumeration Date | 10/25/2023 |
| Last Update Date | 10/25/2023 |
| Medicare PECOS PAC ID | 2668824715 |
|---|---|
| Medicare Enrollment ID | O20240115000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477325249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Patrick Vanschoyck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124088083 PECOS PAC ID: 0941302962 Enrollment ID: I20070222000200 |
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