| Hornet Healthcare | |
|
803 N Foreman St Suite 102 Vinita OK 74301-1412 | |
| (918) 256-2261 | |
| (918) 256-2304 |
| Full Name | Hornet Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 803 N Foreman St, Vinita, Oklahoma |
| Authorized Official Name and Position | Mickey Ray Tyrrell (OWNER) |
| Authorized Official Contact | 9182562261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hornet Healthcare 803 N Foreman St Suite 102 Vinita OK 74301-1412 Ph: (918) 256-2261 | Hornet Healthcare 803 N Foreman St Suite 102 Vinita OK 74301-1412 Ph: (918) 256-2261 |
| NPI Number | 1598962771 |
|---|---|
| Provider Enumeration Date | 06/29/2007 |
| Last Update Date | 09/01/2016 |
| Medicare PECOS PAC ID | 6204856552 |
|---|---|
| Medicare Enrollment ID | O20051201000071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598962771 | NPI | - | NPPES |
| 200067580A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 22897 (Oklahoma) | Primary |
| Provider Name | Mickey R Tyrrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710925680 PECOS PAC ID: 7618909383 Enrollment ID: I20051107000550 |
| Provider Name | Jodee Sue Carrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013391689 PECOS PAC ID: 2961717806 Enrollment ID: I20150917002250 |
| Provider Name | Brooke N Bullard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871244780 PECOS PAC ID: 2961899109 Enrollment ID: I20220419000037 |
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Russell Kohl , Md, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 803 N Foreman St, Vinita, OK 74301 Phone: 918-256-2257 Fax: 918-256-2316 | |
Vinita Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27371 S 4410 Rd, Vinita, OK 74301 Phone: 918-256-4800 Fax: 918-313-0081 | |
Northeast Oklahoma Clinical Partners, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 735 N Foreman St, Vinita, OK 74301 Phone: 918-256-0252 |