Full Name | |
---|---|
Speciality | Family Medicine |
Location | 810 9th St, Prague, Oklahoma |
Authorized Official Name and Position | Melinda Kay Whitaker (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 9187012313 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1809 E 13th St Ste 300 Tulsa OK 74104-4431 Ph: (918) 701-2313 | 810 9th St Prague OK 74864-4582 Ph: (405) 566-3411 |
NPI Number | 1275093098 |
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Provider Enumeration Date | 03/20/2019 |
Last Update Date | 05/30/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275093098 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Rose Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3204 Nbu, 1022 W Main St, Prague, OK 74864 Phone: 405-567-1169 | |