| Jason Mchenry Pa Inc | |
|
110 W 1st St Broken Bow OK 74728-3902 | |
| (580) 584-7210 | |
| Not Available |
| Full Name | Jason Mchenry Pa Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 110 W 1st St, Broken Bow, Oklahoma |
| Authorized Official Name and Position | Jason R Mchnery (OWNER) |
| Authorized Official Contact | 5805847210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Mchenry Pa Inc 110 W 1st Street Broken Bow OK 74728-3901 Ph: (580) 584-7210 | Jason Mchenry Pa Inc 110 W 1st St Broken Bow OK 74728-3902 Ph: (580) 584-7210 |
| NPI Number | 1912126335 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 08/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912126335 | NPI | - | NPPES |
| 200015540B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | PA1255 (Oklahoma) | Primary |
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