Ne Family Medical Clinic Inc | |
2004 N Martin Luther King Ave Oklahoma City OK 73111-1408 | |
(405) 650-1612 | |
(405) 944-8223 |
Full Name | Ne Family Medical Clinic Inc |
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Speciality | Clinic/Center |
Location | 2004 N Martin Luther King Ave, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Ira Thomas (APRN) |
Authorized Official Contact | 4056501612 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ne Family Medical Clinic Inc 2004 N Martin Luther King Ave Oklahoma City OK 73111-1408 Ph: (405) 650-1612 | Ne Family Medical Clinic Inc 2004 N Martin Luther King Ave Oklahoma City OK 73111-1408 Ph: (405) 650-1612 |
NPI Number | 1235840893 |
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Provider Enumeration Date | 12/05/2022 |
Last Update Date | 12/05/2022 |
Medicare PECOS PAC ID | 2163893801 |
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Medicare Enrollment ID | O20230117002453 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235840893 | NPI | - | NPPES |
200921450A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Ira Arthur Thomas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003453580 PECOS PAC ID: 1658797394 Enrollment ID: I20200812002428 |
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