| Nr Midwest City Llc | |
|
8121 National Ave Ste 105 Midwest City OK 73110-7570 | |
| (405) 694-4042 | |
| Not Available |
| Full Name | Nr Midwest City Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8121 National Ave Ste 105, Midwest City, Oklahoma |
| Authorized Official Name and Position | Timothy Coit Bales (CEO) |
| Authorized Official Contact | 4055016261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nr Midwest City Llc 3908 N Peniel Ave Ste 450 Bethany OK 73008-3402 Ph: (405) 495-7391 | Nr Midwest City Llc 8121 National Ave Ste 105 Midwest City OK 73110-7570 Ph: (405) 694-4042 |
| NPI Number | 1558063784 |
|---|---|
| Provider Enumeration Date | 03/21/2023 |
| Last Update Date | 03/21/2023 |
| Medicare PECOS PAC ID | 9830554377 |
|---|---|
| Medicare Enrollment ID | O20230504003259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558063784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Secondary |
| Provider Name | Anne A Munson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275584849 PECOS PAC ID: 3375508468 Enrollment ID: I20041201000001 |
| Provider Name | Stacey Lynn Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730582701 PECOS PAC ID: 5799007514 Enrollment ID: I20141205001965 |
| Provider Name | Nicole Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699276402 PECOS PAC ID: 2264796275 Enrollment ID: I20180427000897 |
| Provider Name | Amber Dawn Zamora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043872856 PECOS PAC ID: 1557692241 Enrollment ID: I20191010001450 |
| Provider Name | Mary Claire J Carbonell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457956286 PECOS PAC ID: 4385051473 Enrollment ID: I20210408001313 |
| Provider Name | Tanya R. Cates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629699244 PECOS PAC ID: 1658776430 Enrollment ID: I20210817001091 |
| Provider Name | Latrica Louise Dorsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538696083 PECOS PAC ID: 1658777024 Enrollment ID: I20210909003063 |
| Provider Name | Brieana Kay Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952875981 PECOS PAC ID: 3678944162 Enrollment ID: I20230119003033 |
Grace Mata Ruidera, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8121 National Ave, Suite 309, Midwest City, OK 73110 Phone: 405-732-3990 | |
Mid-del Family Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 S Douglas Blvd, Midwest City, OK 73130 Phone: 405-736-6811 Fax: 405-736-6863 | |
Dubois Medical Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1117 S Douglas Blvd, Ste D, Midwest City, OK 73130 Phone: 405-741-8686 Fax: 405-733-9621 | |
Midway Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 351 N Air Depot Blvd, Suite Bb, Midwest City, OK 73110 Phone: 405-610-3600 Fax: 405-610-3607 |