Central Oklahoma Foot And Ankle Center Of Edmond | |
105 S Bryant Ave Ste 104 Edmond OK 73034-6361 | |
(405) 715-3102 | |
(405) 715-2905 |
Full Name | Central Oklahoma Foot And Ankle Center Of Edmond |
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Speciality | Clinic/Center |
Location | 105 S Bryant Ave Ste 104, Edmond, Oklahoma |
Authorized Official Name and Position | Stephanie Jones (DIRECTOR OF PATIENT ACCOUNTING) |
Authorized Official Contact | 4052718132 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Central Oklahoma Foot And Ankle Center Of Edmond Po Box 744506 Atlanta GA 30374-4506 Ph: (405) 271-8132 | Central Oklahoma Foot And Ankle Center Of Edmond 105 S Bryant Ave Ste 104 Edmond OK 73034-6361 Ph: (405) 715-3102 |
NPI Number | 1033362231 |
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Provider Enumeration Date | 10/31/2008 |
Last Update Date | 02/13/2019 |
Medicare PECOS PAC ID | 5395809917 |
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Medicare Enrollment ID | O20090127000290 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033362231 | NPI | - | NPPES |
200223730A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Raymond L Smith |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1891794715 PECOS PAC ID: 4486692175 Enrollment ID: I20090127000350 |
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