| Mease Medical Corporation | |
|
659 S 14th Street Jay OK 74346 | |
| (918) 253-6418 | |
| (918) 253-4066 |
| Full Name | Mease Medical Corporation |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 659 S 14th Street, Jay, Oklahoma |
| Authorized Official Name and Position | Darrell R Mease (OWNER) |
| Authorized Official Contact | 9182536418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mease Medical Corporation Po Box 780 Jay OK 74346-0780 Ph: (918) 253-6418 | Mease Medical Corporation 659 S 14th Street Jay OK 74346 Ph: (918) 253-6418 |
| NPI Number | 1265561385 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7719081116 |
|---|---|
| Medicare Enrollment ID | O20070323000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265561385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 16931 (Oklahoma) | Primary |
| 363A00000X | Physician Assistant | PA151 (Oklahoma) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 71128 (Oklahoma) | Primary |
| Provider Name | Darrell R Mease |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952377442 PECOS PAC ID: 7618999202 Enrollment ID: I20051223000016 |
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