| Hydro Medical Clinic Pllc | |
|
579 N Broadway Ave Hydro OK 73048-8425 | |
| (405) 663-2291 | |
| (405) 663-2191 |
| Full Name | Hydro Medical Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 579 N Broadway Ave, Hydro, Oklahoma |
| Authorized Official Name and Position | Brenda Ruth Stutzman (OWNER) |
| Authorized Official Contact | 4056632291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hydro Medical Clinic Pllc 579 N Broadway Ave Hydro OK 73048-8425 Ph: (405) 663-2291 | Hydro Medical Clinic Pllc 579 N Broadway Ave Hydro OK 73048-8425 Ph: (405) 663-2291 |
| NPI Number | 1447404868 |
|---|---|
| Provider Enumeration Date | 11/12/2008 |
| Last Update Date | 04/14/2010 |
| Medicare PECOS PAC ID | 8729119870 |
|---|---|
| Medicare Enrollment ID | O20100706000518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447404868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3099 (Oklahoma) | Primary |
| Provider Name | Brenda R Stutzman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700880127 PECOS PAC ID: 7719945443 Enrollment ID: I20041229000020 |
Oklahoma West Physicians Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 579 N Broadway Ave, Hydro, OK 73048 Phone: 405-663-2291 Fax: 405-663-2121 |