| Muskogee Pediatrics And Family Health Solutions, Llc | |
|
3505 W Broadway St Muskogee OK 74401-2138 | |
| (918) 683-8442 | |
| (918) 683-8390 |
| Full Name | Muskogee Pediatrics And Family Health Solutions, Llc |
|---|---|
| Speciality | Pediatrics |
| Location | 3505 W Broadway St, Muskogee, Oklahoma |
| Authorized Official Name and Position | Rhonda Raneigh Tootill (OWNER) |
| Authorized Official Contact | 9186838442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Muskogee Pediatrics And Family Health Solutions, Llc 3505 W Broadway St Muskogee OK 74401-2138 Ph: (918) 683-8442 | Muskogee Pediatrics And Family Health Solutions, Llc 3505 W Broadway St Muskogee OK 74401-2138 Ph: (918) 683-8442 |
| NPI Number | 1316570690 |
|---|---|
| Provider Enumeration Date | 02/14/2020 |
| Last Update Date | 02/14/2020 |
| Medicare PECOS PAC ID | 7719309970 |
|---|---|
| Medicare Enrollment ID | O20200617002637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316570690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
| Provider Name | Kristin Coffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336410273 PECOS PAC ID: 6103079900 Enrollment ID: I20130103000076 |
| Provider Name | Rhonda Tootill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447677281 PECOS PAC ID: 2264854322 Enrollment ID: I20200617002786 |
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