| Oakes Family Care, Llc Dba The Doctor's Office: Oakes Family Care | |
|
1907 Lisa Drive Ext Greenville MS 38703-4429 | |
| (662) 335-3252 | |
| (662) 269-4480 |
| Full Name | Oakes Family Care, Llc Dba The Doctor's Office: Oakes Family Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1907 Lisa Drive Ext, Greenville, Mississippi |
| Authorized Official Name and Position | Luther Oakes (OWNER) |
| Authorized Official Contact | 6623353252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oakes Family Care, Llc Dba The Doctor's Office: Oakes Family Care 1907 Lisa Drive Ext Greenville MS 38703-4429 Ph: (662) 335-3252 | Oakes Family Care, Llc Dba The Doctor's Office: Oakes Family Care 1907 Lisa Drive Ext Greenville MS 38703-4429 Ph: (662) 335-3252 |
| NPI Number | 1669804910 |
|---|---|
| Provider Enumeration Date | 08/08/2013 |
| Last Update Date | 08/08/2013 |
| Medicare PECOS PAC ID | 1759517709 |
|---|---|
| Medicare Enrollment ID | O20131121000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669804910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 22238 (Mississippi) | Primary |
| Provider Name | Luther Brandon Oakes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215167150 PECOS PAC ID: 1850541558 Enrollment ID: I20130927000260 |
| Provider Name | Holly Nichols Mahalitc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265801682 PECOS PAC ID: 3274837844 Enrollment ID: I20160203000376 |
| Provider Name | Allen B Yelverton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710472790 PECOS PAC ID: 0345590048 Enrollment ID: I20180829004477 |
| Provider Name | Carly M Hazzard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194211094 PECOS PAC ID: 4183977994 Enrollment ID: I20181024002775 |
| Provider Name | Allison A Britt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356985121 PECOS PAC ID: 5496180911 Enrollment ID: I20200110000907 |
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