| Jaroslaw K Paszkowiak Md Pc | |
|
4411 W Gore Blvd Ste B1 Lawton OK 73505-5977 | |
| (580) 248-8000 | |
| Not Available |
| Full Name | Jaroslaw K Paszkowiak Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 4411 W Gore Blvd, Lawton, Oklahoma |
| Authorized Official Name and Position | Jaroslaw Paszkowiak (OWNER) |
| Authorized Official Contact | 5802488000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaroslaw K Paszkowiak Md Pc 4411 W Gore Blvd Ste B1 Lawton OK 73505-5977 Ph: (580) 248-8000 | Jaroslaw K Paszkowiak Md Pc 4411 W Gore Blvd Ste B1 Lawton OK 73505-5977 Ph: (580) 248-8000 |
| NPI Number | 1790887263 |
|---|---|
| Provider Enumeration Date | 09/03/2006 |
| Last Update Date | 02/18/2014 |
| Medicare PECOS PAC ID | 1951307040 |
|---|---|
| Medicare Enrollment ID | O20061012000545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790887263 | NPI | - | NPPES |
| 200082480B | Medicaid | OK | |
| 200095800A | Medicaid | OK | |
| P00435232 | Other | OK | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jaroslaw K Paszkowiak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205899333 PECOS PAC ID: 5597774299 Enrollment ID: I20060504000344 |
| Provider Name | Julia Danielle Ripley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811515414 PECOS PAC ID: 2264881358 Enrollment ID: I20231214002662 |
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