| My Family Clinic Llc | |
|
3717 S Western Ave Oklahoma City OK 73109-3401 | |
| (678) 294-9938 | |
| Not Available |
| Full Name | My Family Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3717 S Western Ave, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Andrew T. Billingsley (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7044565557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Family Clinic Llc Po Box 18228 Oklahoma City OK 73154-0228 Ph: (678) 294-9938 | My Family Clinic Llc 3717 S Western Ave Oklahoma City OK 73109-3401 Ph: (678) 294-9938 |
| NPI Number | 1730565912 |
|---|---|
| Provider Enumeration Date | 08/10/2015 |
| Last Update Date | 08/11/2015 |
| Medicare PECOS PAC ID | 7517277114 |
|---|---|
| Medicare Enrollment ID | O20151111001875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730565912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 31108 (Oklahoma) | Primary |
| Provider Name | Renee Roy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649200361 PECOS PAC ID: 2860446259 Enrollment ID: I20050812000176 |
| Provider Name | Therese D Miner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033148697 PECOS PAC ID: 1153369772 Enrollment ID: I20070228000472 |
| Provider Name | Deanna J Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730259219 PECOS PAC ID: 0648374488 Enrollment ID: I20070403000519 |
| Provider Name | Carol L Hagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609281658 PECOS PAC ID: 7012230865 Enrollment ID: I20141231000121 |
| Provider Name | Charles Pollard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497164396 PECOS PAC ID: 4183942683 Enrollment ID: I20150414000120 |
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