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519 N Main St Bristow OK 74010-2016 | |
(918) 367-6611 | |
(918) 367-9915 |
Full Name | |
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Speciality | Family Medicine |
Location | 519 N Main St, Bristow, 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 |
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1809 E 13th St Ste 300 Tulsa OK 74104-4431 Ph: (918) 701-2313 | 519 N Main St Bristow OK 74010-2016 Ph: (918) 367-6611 |
NPI Number | 1265863583 |
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Provider Enumeration Date | 12/12/2013 |
Last Update Date | 11/18/2022 |
Identifier | Type | State | Issuer |
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1265863583 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207Y00000X | Otolaryngology | (* (Not Available)) | Secondary |
208600000X | Surgery | (* (Not Available)) | Secondary |
Carrus Lakeside Hospital Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 W 7th Ave Ste 102, Bristow, OK 74010 Phone: 918-367-2215 Fax: 918-367-4481 | |
Snyder Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 519 N Main St, Bristow, OK 74010 Phone: 918-367-3272 | |