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511 E 1st St Chandler OK 74834-2439 | |
| (405) 654-0013 | |
| (405) 654-0012 |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 511 E 1st St, Chandler, Oklahoma |
| Authorized Official Name and Position | Samantha Bollich (ALT. MANAGER) |
| Authorized Official Contact | 4056540013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
511 E 1st St Chandler OK 74834-2439 Ph: (405) 654-0013 | 511 E 1st St Chandler OK 74834-2439 Ph: (405) 654-0013 |
| NPI Number | 1447659768 |
|---|---|
| Provider Enumeration Date | 08/22/2014 |
| Last Update Date | 03/31/2021 |
| Medicare PECOS PAC ID | 7012138662 |
|---|---|
| Medicare Enrollment ID | O20141023000670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447659768 | NPI | - | NPPES |
| 200564250C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Long T Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811956006 PECOS PAC ID: 2163413543 Enrollment ID: I20040524000651 |
| Provider Name | Alex Dwuma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417275041 PECOS PAC ID: 5698926111 Enrollment ID: I20131217000808 |
| Provider Name | David Dawson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1053340505 PECOS PAC ID: 9830176106 Enrollment ID: I20160503000107 |
| Provider Name | Jimmy Bui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649653833 PECOS PAC ID: 4981909462 Enrollment ID: I20160809000605 |
| Provider Name | Nicole Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699276402 PECOS PAC ID: 2264796275 Enrollment ID: I20180427000897 |
| Provider Name | Amber L Surz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619524683 PECOS PAC ID: 1456683564 Enrollment ID: I20191022003254 |
| Provider Name | Randi J Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588299952 PECOS PAC ID: 1052740925 Enrollment ID: I20200330000889 |
| Provider Name | Anny Lou Mandapat Dunham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194368316 PECOS PAC ID: 3476926015 Enrollment ID: I20230302001307 |
| Provider Name | Arika L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588365936 PECOS PAC ID: 6002271178 Enrollment ID: I20230424002634 |
| Provider Name | Ngwengyi Nkeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912695677 PECOS PAC ID: 3971046053 Enrollment ID: I20240617003935 |
Mark G Miles Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 339350 E 850 Rd, Chandler, OK 74834 Phone: 405-601-6181 Fax: 405-601-7012 | |
Oklahoma Mental Health Council Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Mckinley Ave, Chandler, OK 74834 Phone: 405-424-7711 | |
Chandler Clinic A Division Of Plaza Medical Group, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 N Highway 18, Chandler, OK 74834 Phone: 405-258-2500 | |
Chandler Outreach Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1406 Manvel Ave, Ste C, Chandler, OK 74834 Phone: 405-258-5252 Fax: 405-258-5552 | |
Best Care Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 511 E 1st St, Chandler, OK 74834 Phone: 405-654-0013 |