Community Clinic Of Beaver | |
718 Ave. A Beaver OK 73932-3101 | |
(580) 625-3477 | |
(580) 625-3562 |
Full Name | Community Clinic Of Beaver |
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Speciality | Clinic/Center |
Location | 718 Ave. A, Beaver, Oklahoma |
Authorized Official Name and Position | Brent Meyers (ADMINISTRATOR) |
Authorized Official Contact | 5806254551 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Clinic Of Beaver Po Box 640 Beaver OK 73932-0640 Ph: (580) 625-3477 | Community Clinic Of Beaver 718 Ave. A Beaver OK 73932-3101 Ph: (580) 625-3477 |
NPI Number | 1487631156 |
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Provider Enumeration Date | 12/23/2005 |
Last Update Date | 04/15/2010 |
Medicare PECOS PAC ID | 9335134246 |
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Medicare Enrollment ID | O20040419001694 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487631156 | NPI | - | NPPES |
100700760F | Medicaid | OK | |
100700760H | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 2242 (Oklahoma) | Primary |
Provider Name | Susan Danielle Trippet |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346367711 PECOS PAC ID: 7618004375 Enrollment ID: I20100428000946 |
Provider Name | Aaron S Sizelove |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053547950 PECOS PAC ID: 7618131160 Enrollment ID: I20120612000659 |
Provider Name | Lynnetta Faye Stout |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609027036 PECOS PAC ID: 2668604489 Enrollment ID: I20140410000071 |
Provider Name | Jennifer Jo Sparks |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780041384 PECOS PAC ID: 1153713417 Enrollment ID: I20220118001152 |
Provider Name | Scotty King |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750024741 PECOS PAC ID: 9830579408 Enrollment ID: I20220629002714 |
Alliance Health Woodward Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 623 Avenue C, Beaver, OK 73932 Phone: 580-625-2273 Fax: 580-625-2274 | |
Alliancehealth Woodward Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 623 Avenue C, Beaver, OK 73932 Phone: 580-625-2273 Fax: 580-625-2274 | |
High Plains Medical Specialists Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 623 Avenue C, Beaver, OK 73932 Phone: 580-625-4854 Fax: 580-625-4854 |