| Dr James Forrestal Inc | |
|
830 16th Ave Nw Ardmore OK 73401-1818 | |
| (580) 226-5120 | |
| (580) 223-1003 |
| Full Name | Dr James Forrestal Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 830 16th Ave Nw, Ardmore, Oklahoma |
| Authorized Official Name and Position | James Forrestal Inc (OWNER) |
| Authorized Official Contact | 5802265120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr James Forrestal Inc 830 16th Ave Nw Ardmore OK 73401-1818 Ph: (580) 226-5120 | Dr James Forrestal Inc 830 16th Ave Nw Ardmore OK 73401-1818 Ph: (580) 226-5120 |
| NPI Number | 1376641712 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 05/14/2014 |
| Medicare PECOS PAC ID | 0042349227 |
|---|---|
| Medicare Enrollment ID | O20100526000706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376641712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2309 (Oklahoma) | Primary |
| Provider Name | James E Forrestal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285611160 PECOS PAC ID: 7810026002 Enrollment ID: I20100526000799 |
| Provider Name | Heather Lea Moiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457790974 PECOS PAC ID: 9830412253 Enrollment ID: I20141216000571 |
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