| Pauls Valley Family Healthcare Aprn Fnp-bc Llc | |
|
34550 Airline Rd Pauls Valley OK 73075-9337 | |
| (405) 207-9238 | |
| (405) 207-9240 |
| Full Name | Pauls Valley Family Healthcare Aprn Fnp-bc Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 34550 Airline Rd, Pauls Valley, Oklahoma |
| Authorized Official Name and Position | Scotty Eugene Jackson (NURSE PRACTITIONER / OWNER) |
| Authorized Official Contact | 4052079238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pauls Valley Family Healthcare Aprn Fnp-bc Llc 34550 Airline Rd Pauls Valley OK 73075-9337 Ph: (405) 207-9238 | Pauls Valley Family Healthcare Aprn Fnp-bc Llc 34550 Airline Rd Pauls Valley OK 73075-9337 Ph: (405) 207-9238 |
| NPI Number | 1407553597 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 04/20/2023 |
| Medicare PECOS PAC ID | 1254705395 |
|---|---|
| Medicare Enrollment ID | O20230313002080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407553597 | NPI | - | NPPES |
| 211329 | Other | OK | OKLAHOMA STATE BOARD OF NURSING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Scotty Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750095980 PECOS PAC ID: 2163896200 Enrollment ID: I20230313002174 |
Charles N. Howard, Jr., M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 W Guy Ave, Pauls Valley, OK 73075 Phone: 405-238-9343 Fax: 405-238-9346 | |
Ccf Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Valley Dr, Pauls Valley, OK 73075 Phone: 405-331-5128 | |
Pauls Valley Physicians Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Valley Dr, Pauls Valley, OK 73075 Phone: 405-238-5501 Fax: 405-238-5396 | |
Andrew Thyen Mdpa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Melville Dr, Pauls Valley, OK 73075 Phone: 405-238-5555 | |
Carefirst Wellness & Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Melville Dr, Pauls Valley, OK 73075 Phone: 405-331-5128 Fax: 405-867-4406 | |
Valley Family Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Burr Ave, Pauls Valley, OK 73075 Phone: 405-238-4633 Fax: 405-238-4690 |