Caney Valley Medical Clinic | |
400 Wyandotte Ramona OK 74061 | |
(918) 536-1024 | |
(918) 536-2203 |
Full Name | Caney Valley Medical Clinic |
---|---|
Speciality | Family Medicine |
Location | 400 Wyandotte, Ramona, Oklahoma |
Authorized Official Name and Position | John Hibdon (ADMINISTRATOR) |
Authorized Official Contact | 9185361024 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Caney Valley Medical Clinic 400 Wyandotte Ramona OK 74061 Ph: (918) 536-1024 | Caney Valley Medical Clinic 400 Wyandotte Ramona OK 74061 Ph: (918) 536-1024 |
NPI Number | 1356406292 |
---|---|
Provider Enumeration Date | 12/22/2006 |
Last Update Date | 12/19/2013 |
Medicare PECOS PAC ID | 6800887621 |
---|---|
Medicare Enrollment ID | O20040520000984 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356406292 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | James Millar |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437121316 PECOS PAC ID: 4880595313 Enrollment ID: I20040117000152 |
Provider Name | James E Crutcher |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740253129 PECOS PAC ID: 1254232259 Enrollment ID: I20040122000127 |
Provider Name | John W Tipton |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316937220 PECOS PAC ID: 7214830769 Enrollment ID: I20040130000880 |
Provider Name | William M Woods |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1831296219 PECOS PAC ID: 0648258327 Enrollment ID: I20040709000415 |
Provider Name | Russell W Kohl |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1114953437 PECOS PAC ID: 3375597172 Enrollment ID: I20050430000082 |
Provider Name | Matthew L West |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508884313 PECOS PAC ID: 0749285716 Enrollment ID: I20060926000049 |
Provider Name | Hester I Ferguson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104372275 PECOS PAC ID: 5799065827 Enrollment ID: I20161207002009 |
Dr. John C. Leatherman Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Wyandotte Pl, Ramona, OK 74061 Phone: 918-536-1024 Fax: 918-536-4003 |