Enlow Family Practice | |
1203 E Ross Byp Suite A Tahlequah OK 74464-4133 | |
(918) 453-1234 | |
(918) 453-9107 |
Full Name | Enlow Family Practice |
---|---|
Speciality | Family Medicine |
Location | 1203 E Ross Byp, Tahlequah, Oklahoma |
Authorized Official Name and Position | Lisa A Swarer (MANAGER) |
Authorized Official Contact | 9184531234 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Enlow Family Practice 1203 E Ross Byp Suite A Tahlequah OK 74464-4133 Ph: (918) 453-1234 | Enlow Family Practice 1203 E Ross Byp Suite A Tahlequah OK 74464-4133 Ph: (918) 453-1234 |
NPI Number | 1659568301 |
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Provider Enumeration Date | 09/26/2007 |
Last Update Date | 04/29/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659568301 | NPI | - | NPPES |
600522432 | Other | OK | MEDICARE GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | R0067005 (Oklahoma) | Primary |
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