| Idcokc Pllc | |
|
4221 S Western Ave Ste 4010 Oklahoma City OK 73109-3492 | |
| (405) 644-6464 | |
| (405) 644-6465 |
| Full Name | Idcokc Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4221 S Western Ave Ste 4010, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Jarrod Louis Rees (ADMIN) |
| Authorized Official Contact | 4056446464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idcokc Pllc 4221 S Western Ave Ste 4010 Oklahoma City OK 73109-3492 Ph: (405) 644-6464 | Idcokc Pllc 4221 S Western Ave Ste 4010 Oklahoma City OK 73109-3492 Ph: (405) 644-6464 |
| NPI Number | 1851078059 |
|---|---|
| Provider Enumeration Date | 06/29/2023 |
| Last Update Date | 06/29/2023 |
| Medicare PECOS PAC ID | 0749631745 |
|---|---|
| Medicare Enrollment ID | O20240103003833 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851078059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | David H Chansolme |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457343402 PECOS PAC ID: 1557331782 Enrollment ID: I20040729000007 |
| Provider Name | Andrea Scott |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346406899 PECOS PAC ID: 1557530862 Enrollment ID: I20141006000272 |
| Provider Name | Miranda A Mcghee |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1538547336 PECOS PAC ID: 5799075206 Enrollment ID: I20210722000161 |
| Provider Name | Mark Patrick Verity |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811345911 PECOS PAC ID: 2264836030 Enrollment ID: I20210802003183 |
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