| Paragon Geriatric Associates, Pllc | |
|
5601 Nw 72nd St Ste 245 Warr Acres OK 73132-5948 | |
| (405) 400-7557 | |
| (844) 868-8139 |
| Full Name | Paragon Geriatric Associates, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5601 Nw 72nd St Ste 245, Warr Acres, Oklahoma |
| Authorized Official Name and Position | Stephen Lavern Vernier (OWNER) |
| Authorized Official Contact | 4054007557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paragon Geriatric Associates, Pllc 5601 Nw 72nd St Ste 245 Warr Acres OK 73132-5948 Ph: (405) 400-7557 | Paragon Geriatric Associates, Pllc 5601 Nw 72nd St Ste 245 Warr Acres OK 73132-5948 Ph: (405) 400-7557 |
| NPI Number | 1093382467 |
|---|---|
| Provider Enumeration Date | 06/05/2021 |
| Last Update Date | 06/05/2021 |
| Medicare PECOS PAC ID | 9537561147 |
|---|---|
| Medicare Enrollment ID | O20210706000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093382467 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Stephen L Vernier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972532281 PECOS PAC ID: 6608839063 Enrollment ID: I20041105001008 |
| Provider Name | Jamie L. Breedlove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124415815 PECOS PAC ID: 9931410289 Enrollment ID: I20160628001343 |
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Revan Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5601 Nw 72nd St Ste 142, Warr Acres, OK 73132 Phone: 405-896-7975 Fax: 866-473-0490 | |
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