Main Street Family Medical, Llc | |
701 W Broadway St Spiro OK 74959-2456 | |
(918) 962-8009 | |
(918) 962-8027 |
Full Name | Main Street Family Medical, Llc |
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Speciality | Clinic/Center |
Location | 701 W Broadway St, Spiro, Oklahoma |
Authorized Official Name and Position | Elizabeth Trudy Davis (FOUNDER) |
Authorized Official Contact | 9184487854 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Main Street Family Medical, Llc 32415 Peach Creek Rd Red Oak OK 74563-1101 Ph: (918) 448-7854 | Main Street Family Medical, Llc 701 W Broadway St Spiro OK 74959-2456 Ph: (918) 962-8009 |
NPI Number | 1952025249 |
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Provider Enumeration Date | 09/29/2022 |
Last Update Date | 09/07/2023 |
Medicare PECOS PAC ID | 4981070901 |
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Medicare Enrollment ID | O20221017001922 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952025249 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Elizabeth Trudy Davis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033837000 PECOS PAC ID: 5890161814 Enrollment ID: I20221017002065 |
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Marcella P Jones Do Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 701 W Broadway St, Spiro, OK 74959 Phone: 866-243-7203 Fax: 833-243-7203 | |
Spiro Family Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 W Broadway St, Spiro, OK 74959 Phone: 918-962-2442 Fax: 918-962-3895 | |
Osu Center For Health Sciences Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 W Broadway St, Spiro, OK 74959 Phone: 918-962-2442 Fax: 918-962-3895 |