| Perry A. Klaassen Family Medical Center | |
|
1901 Springlake Drive Oklahoma City OK 73111-5201 | |
| (405) 521-8486 | |
| (405) 521-8486 |
| Full Name | Perry A. Klaassen Family Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1901 Springlake Drive, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Isabella Lawson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4057693301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perry A. Klaassen Family Medical Center Po Box 30589 Midwest City OK 73140 Ph: (405) 769-3301 | Perry A. Klaassen Family Medical Center 1901 Springlake Drive Oklahoma City OK 73111-5201 Ph: (405) 521-8486 |
| NPI Number | 1376725812 |
|---|---|
| Provider Enumeration Date | 11/27/2007 |
| Last Update Date | 04/28/2020 |
| Medicare PECOS PAC ID | 4688584436 |
|---|---|
| Medicare Enrollment ID | O20080115000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376725812 | NPI | - | NPPES |
| 100709120B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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