| Citizen Potawatomi Nation Clinic | |
|
2307 S Gordon Cooper Dr Shawnee OK 74801-9007 | |
| (405) 273-5236 | |
| (405) 878-4835 |
| Full Name | Citizen Potawatomi Nation Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2307 S Gordon Cooper Dr, Shawnee, Oklahoma |
| Authorized Official Name and Position | Chris Skillings (DIRECTOR OF HEALTH SERVICES) |
| Authorized Official Contact | 4052735236 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citizen Potawatomi Nation Clinic 2307 S Gordon Cooper Dr Shawnee OK 74801-9007 Ph: (405) 273-5236 | Citizen Potawatomi Nation Clinic 2307 S Gordon Cooper Dr Shawnee OK 74801-9007 Ph: (405) 273-5236 |
| NPI Number | 1194752949 |
|---|---|
| Provider Enumeration Date | 06/27/2006 |
| Last Update Date | 11/09/2016 |
| Medicare PECOS PAC ID | 3375511488 |
|---|---|
| Medicare Enrollment ID | O20101004000641 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194752949 | NPI | - | NPPES |
| 100244300C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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