| First Med Primary Care Llc | |
|
1142 Sw 104th St Oklahoma City OK 73139 | |
| (405) 691-3100 | |
| (405) 691-3106 |
| Full Name | First Med Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1142 Sw 104th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Todd Kee (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 4056913100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Med Primary Care Llc 1221 N Kelly Ave Edmond OK 73003-4865 Ph: (405) 691-3100 | First Med Primary Care Llc 1142 Sw 104th St Oklahoma City OK 73139 Ph: (405) 691-3100 |
| NPI Number | 1447899778 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 03/06/2020 |
| Medicare PECOS PAC ID | 5597181461 |
|---|---|
| Medicare Enrollment ID | O20200824000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447899778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Randal A Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124068366 PECOS PAC ID: 8022906114 Enrollment ID: I20040309001378 |
| Provider Name | David M Ha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386977809 PECOS PAC ID: 8224175625 Enrollment ID: I20091016000108 |
| Provider Name | Melinda Kruger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851741052 PECOS PAC ID: 5092097196 Enrollment ID: I20170125002488 |
| Provider Name | Samir A Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740732544 PECOS PAC ID: 7810270030 Enrollment ID: I20170214002600 |
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