Internal Medicine Clinic Pllc | |
410 Ne 12th Street Guymon OK 73942 | |
(580) 338-5500 | |
(580) 468-4942 |
Full Name | Internal Medicine Clinic Pllc |
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Speciality | Internal Medicine |
Location | 410 Ne 12th Street, Guymon, Oklahoma |
Authorized Official Name and Position | Jeffrey J Lim (MEMBER) |
Authorized Official Contact | 5803385500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Internal Medicine Clinic Pllc Po Box 158 410 Ne 12th Street Guymon OK 73942-0158 Ph: (580) 338-5500 | Internal Medicine Clinic Pllc 410 Ne 12th Street Guymon OK 73942 Ph: (580) 338-5500 |
NPI Number | 1164541900 |
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Provider Enumeration Date | 03/29/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 9436253465 |
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Medicare Enrollment ID | O20070402000292 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164541900 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 18750 (Oklahoma) | Primary |
Provider Name | Jeffrey J Lim |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972503241 PECOS PAC ID: 0446274245 Enrollment ID: I20060127000535 |
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