John Belk Family Practice Pllc | |
1103 W Cherokee St Wagoner OK 74467-4621 | |
(580) 647-6594 | |
Not Available |
Full Name | John Belk Family Practice Pllc |
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Speciality | Family Medicine |
Location | 1103 W Cherokee St, Wagoner, Oklahoma |
Authorized Official Name and Position | John Belk (MBR) |
Authorized Official Contact | 5806476594 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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John Belk Family Practice Pllc 1103 W Cherokee St Wagoner OK 74467-4621 Ph: () - | John Belk Family Practice Pllc 1103 W Cherokee St Wagoner OK 74467-4621 Ph: (580) 647-6594 |
NPI Number | 1134655004 |
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Provider Enumeration Date | 05/11/2017 |
Last Update Date | 07/18/2017 |
Medicare PECOS PAC ID | 2860762200 |
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Medicare Enrollment ID | O20170718002987 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134655004 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 30768 (Oklahoma) | Primary |
Provider Name | John Belk |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790199982 PECOS PAC ID: 1759682321 Enrollment ID: I20170718002911 |
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