| Meridian Family Practice, Llc | |
|
5252 N Meridian Ave Suite 105 Oklahoma City OK 73112-2178 | |
| (614) 284-8071 | |
| Not Available |
| Full Name | Meridian Family Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5252 N Meridian Ave, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Clayton H Royder (PHYSICIAN OWNER) |
| Authorized Official Contact | 6142848071 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meridian Family Practice, Llc 5252 N Meridian Ave Ste 105 Oklahoma City OK 73112-2136 Ph: (405) 601-3330 | Meridian Family Practice, Llc 5252 N Meridian Ave Suite 105 Oklahoma City OK 73112-2178 Ph: (614) 284-8071 |
| NPI Number | 1548556764 |
|---|---|
| Provider Enumeration Date | 06/27/2011 |
| Last Update Date | 02/11/2020 |
| Medicare PECOS PAC ID | 2365616091 |
|---|---|
| Medicare Enrollment ID | O20240122003931 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548556764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5009 (Oklahoma) | Primary |
| Provider Name | Clayton H Royder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588969711 PECOS PAC ID: 2860391901 Enrollment ID: I20111115000699 |
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