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411 N Randall Ave Elk City OK 73644-4127 | |
(580) 243-2273 | |
(580) 243-2832 |
Full Name | |
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Speciality | Family Medicine |
Location | 411 N Randall Ave, Elk City, Oklahoma |
Authorized Official Name and Position | Erick Charles Derocher (PRESIDENT) |
Authorized Official Contact | 5802432273 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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411 N Randall Ave Elk City OK 73644-4127 Ph: (580) 243-2273 | 411 N Randall Ave Elk City OK 73644-4127 Ph: (580) 243-2273 |
NPI Number | 1316039688 |
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Provider Enumeration Date | 09/28/2006 |
Last Update Date | 06/25/2008 |
Medicare PECOS PAC ID | 0547271504 |
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Medicare Enrollment ID | O20060505000612 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316039688 | NPI | - | NPPES |
200081510A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OK2573 (Oklahoma) | Primary |
Provider Name | Amanda L Lafarlette |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255343638 PECOS PAC ID: 4981613221 Enrollment ID: I20060505000741 |
Provider Name | Erick C Derocher |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750393260 PECOS PAC ID: 7810963659 Enrollment ID: I20060509000096 |
Provider Name | Kasee Mcarthur |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154798759 PECOS PAC ID: 4385952480 Enrollment ID: I20151008001961 |
Whinery Family Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1710 W 3rd St, Suite 103, Elk City, OK 73644 Phone: 580-225-1290 Fax: 580-225-2178 | |
Skinner Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 607 S Main St, Elk City, OK 73644 Phone: 580-977-4721 Fax: 605-273-3695 | |
Scott A Williams D O P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 W 3rd St, Suite A, Elk City, OK 73644 Phone: 580-225-2663 Fax: 580-225-2373 | |
Jamie L Gore Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 W 3rd St, Elk City, OK 73644 Phone: 580-225-5900 |