| Memorial Health Group Llc | |
|
8131 S Memorial Dr Ste 100 Tulsa OK 74133-4348 | |
| (918) 200-9944 | |
| Not Available |
| Full Name | Memorial Health Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8131 S Memorial Dr Ste 100, Tulsa, Oklahoma |
| Authorized Official Name and Position | Matthew Dyer (OWNER) |
| Authorized Official Contact | 9188085629 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Health Group Llc 8131 S Memorial Dr Ste 100 Tulsa OK 74133-4348 Ph: (918) 200-9944 | Memorial Health Group Llc 8131 S Memorial Dr Ste 100 Tulsa OK 74133-4348 Ph: (918) 200-9944 |
| NPI Number | 1619664307 |
|---|---|
| Provider Enumeration Date | 04/21/2023 |
| Last Update Date | 08/03/2023 |
| Medicare PECOS PAC ID | 4082073093 |
|---|---|
| Medicare Enrollment ID | O20230710001508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619664307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Caroline Wescott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992138937 PECOS PAC ID: 4880829837 Enrollment ID: I20131028001446 |
| Provider Name | Leslie Chan |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1912039850 PECOS PAC ID: 6002988037 Enrollment ID: I20160615000092 |
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