| Eagle Community Clinic Llc | |
|
13800 Benson Rd 202 Edmond OK 73013-6422 | |
| (405) 418-3077 | |
| (405) 418-3076 |
| Full Name | Eagle Community Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 13800 Benson Rd, Edmond, Oklahoma |
| Authorized Official Name and Position | Brandon L Penick (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Contact | 4053606764 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Community Clinic Llc Po Box 5995 Norman OK 73070-5995 Ph: (405) 360-6764 | Eagle Community Clinic Llc 13800 Benson Rd 202 Edmond OK 73013-6422 Ph: (405) 418-3077 |
| NPI Number | 1063790202 |
|---|---|
| Provider Enumeration Date | 07/21/2011 |
| Last Update Date | 07/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063790202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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