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101 S Park Ln Suite 100 Altus OK 73521-5731 | |
(580) 379-6100 | |
(580) 379-6109 |
Full Name | |
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Speciality | Clinic/Center |
Location | 101 S Park Ln, Altus, Oklahoma |
Authorized Official Name and Position | Steve Hartgraves (PRESIDENT/CEO) |
Authorized Official Contact | 5803795500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1200 E Pecan St Altus OK 73521-6141 Ph: (580) 379-5000 | 101 S Park Ln Suite 100 Altus OK 73521-5731 Ph: (580) 379-6100 |
NPI Number | 1407230790 |
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Provider Enumeration Date | 07/16/2015 |
Last Update Date | 10/06/2022 |
Medicare PECOS PAC ID | 1759293178 |
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Medicare Enrollment ID | O20150922000568 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407230790 | NPI | - | NPPES |
200688750A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Altus Chiropractic Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 903 Falcon Rd, Altus, OK 73521 Phone: 580-482-4499 Fax: 580-482-4449 | |
Noble L Ballard.medical Clinic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1015 East Broadway Street, Stuite 101, Altus, OK 73521 Phone: 580-480-1900 Fax: 580-477-1936 | |