| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2525 Cornwell Drive, Yukon, Oklahoma |
| Authorized Official Name and Position | Dave M Wilcox (OWNER) |
| Authorized Official Contact | 4052652300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2525 Cornwell Drive Yukon OK 73099 Ph: (405) 265-2300 | 2525 Cornwell Drive Yukon OK 73099 Ph: (405) 265-2300 |
| NPI Number | 1417408170 |
|---|---|
| Provider Enumeration Date | 10/18/2016 |
| Last Update Date | 10/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417408170 | NPI | - | NPPES |
| 1588982672 | Other | OK | NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Oklahoma) | Primary |
Aquilo Medical Home Team Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1491 Health Center Pkwy, Yukon, OK 73099 Phone: 405-990-6654 | |
Michael D. Furgeson, M. D.,inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 508 W Vandament Ave, Suite 100, Yukon, OK 73099 Phone: 405-350-8100 Fax: 405-350-6418 | |
Catrina Bourne, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1820 Commons Cir, Suite A, Yukon, OK 73099 Phone: 405-265-2778 Fax: 405-494-7274 | |
Nr Yukon Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12801 Nw 10th St, Yukon, OK 73099 Phone: 405-914-6677 Fax: 405-669-3517 |