| Auxilium Health Network, Llc | |
|
3300 S Aspen Ave Ste C Broken Arrow OK 74012-7501 | |
| (918) 455-2416 | |
| Not Available |
| Full Name | Auxilium Health Network, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3300 S Aspen Ave Ste C, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Fungwah Chris Ruiz (CEO) |
| Authorized Official Contact | 6263215755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Auxilium Health Network, Llc 3300 S Aspen Ave Ste C Broken Arrow OK 74012-7501 Ph: (918) 455-2416 | Auxilium Health Network, Llc 3300 S Aspen Ave Ste C Broken Arrow OK 74012-7501 Ph: (918) 455-2416 |
| NPI Number | 1982311734 |
|---|---|
| Provider Enumeration Date | 11/01/2022 |
| Last Update Date | 11/05/2022 |
| Medicare PECOS PAC ID | 4981074119 |
|---|---|
| Medicare Enrollment ID | O20230105000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982311734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kash K Biddle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073566659 PECOS PAC ID: 8224101894 Enrollment ID: I20080716000227 |
| Provider Name | Carmen Oakes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003040528 PECOS PAC ID: 6406049527 Enrollment ID: I20101021000919 |
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