Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 2321 E 3rd Street, Tulsa, Oklahoma |
Authorized Official Name and Position | Jeff Faust (HR MANAGER) |
Authorized Official Contact | 9186220641 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
2321 E 3rd Street Tulsa OK 74104 Ph: (918) 622-0641 | 2321 E 3rd Street Tulsa OK 74104 Ph: (918) 622-0641 |
NPI Number | 1255612040 |
---|---|
Provider Enumeration Date | 09/07/2011 |
Last Update Date | 09/20/2016 |
Medicare PECOS PAC ID | 5991756397 |
---|---|
Medicare Enrollment ID | O20111107000495 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255612040 | NPI | - | NPPES |
200082520B | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oklahoma) | Primary |
Tulsa Internal Medicine Physicians, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2000 S Wheeling Ave, Ste 1000, Tulsa, OK 74104 Phone: 918-748-8467 | |
Community Health Connection, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13702 E 46th Pl, Tulsa, OK 74134 Phone: 918-622-0641 Fax: 918-622-4814 | |
Qt Quikmed Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4705 S 129th East Ave, Tulsa, OK 74134 Phone: 918-994-3953 | |
Careatc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 N 161st East Ave, Tulsa, OK 74116 Phone: 800-993-8244 |