| |
900 E 13th St Suite 104 Grove OK 74344-2975 | |
(918) 786-3100 | |
(918) 786-3108 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 900 E 13th St, Grove, Oklahoma |
Authorized Official Name and Position | Renee Jean Russell (PROVIDER) |
Authorized Official Contact | 9187863100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1110 Neo Loop Grove OK 74344-6046 Ph: (918) 786-3100 | 900 E 13th St Suite 104 Grove OK 74344-2975 Ph: (918) 786-3100 |
NPI Number | 1316092182 |
---|---|
Provider Enumeration Date | 01/24/2007 |
Last Update Date | 11/11/2016 |
Medicare PECOS PAC ID | 6406956234 |
---|---|
Medicare Enrollment ID | O20070710000295 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316092182 | NPI | - | NPPES |
100017290D | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 22021 (Oklahoma) | Primary |
Provider Name | Renee J Russell |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245286921 PECOS PAC ID: 6709880909 Enrollment ID: I20060907000582 |
Renee J. Zarintash, M.d., P.l.l.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E 13th St, Suite 104, Grove, OK 74344 Phone: 918-786-3100 Fax: 918-786-3108 | |
Northeast Oklahoma Family Practice & Obstetrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 E 13th St, Suite H, Grove, OK 74344 Phone: 918-786-4664 Fax: 918-786-4256 | |
Family Care Spec, Inc., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 E 13th St Ste C, Grove, OK 74344 Phone: 918-786-6151 Fax: 918-786-3483 |