| King's Court Family Medicine | |
|
9222 S Elwood Ave Ste C Jenks OK 74037-2369 | |
| (918) 322-0099 | |
| (918) 925-9966 |
| Full Name | King's Court Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 9222 S Elwood Ave Ste C, Jenks, Oklahoma |
| Authorized Official Name and Position | Amy Talley (ASSISTANT MANAGER) |
| Authorized Official Contact | 9183220099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| King's Court Family Medicine 9222 S Elwood Ave Ste C Jenks OK 74037-2369 Ph: (918) 322-0099 | King's Court Family Medicine 9222 S Elwood Ave Ste C Jenks OK 74037-2369 Ph: (918) 322-0099 |
| NPI Number | 1235468745 |
|---|---|
| Provider Enumeration Date | 12/11/2009 |
| Last Update Date | 07/27/2021 |
| Medicare PECOS PAC ID | 3274662325 |
|---|---|
| Medicare Enrollment ID | O20100527000414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235468745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4427 (Oklahoma) | Primary |
| Provider Name | Bryan Kent Ledbetter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194807024 PECOS PAC ID: 5597823716 Enrollment ID: I20081016000447 |
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