Janet Fanning, Md Pc | |
416 Sw 79th St Ste 100 Oklahoma City OK 73139 | |
(405) 702-4777 | |
(405) 770-4770 |
Full Name | Janet Fanning, Md Pc |
---|---|
Speciality | Family Medicine |
Location | 416 Sw 79th St Ste 100, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Janet Fanning (OWNER) |
Authorized Official Contact | 4056295343 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Janet Fanning, Md Pc 416 Sw 79th St Ste 100 Oklahoma City OK 73139-8121 Ph: (405) 702-4777 | Janet Fanning, Md Pc 416 Sw 79th St Ste 100 Oklahoma City OK 73139 Ph: (405) 702-4777 |
NPI Number | 1437570223 |
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Provider Enumeration Date | 12/20/2013 |
Last Update Date | 11/30/2018 |
Medicare PECOS PAC ID | 0840410940 |
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Medicare Enrollment ID | O20141010002255 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437570223 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Janet L Fanning |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396786737 PECOS PAC ID: 5092772509 Enrollment ID: I20041216000461 |
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