| Prague Family Clinic | |
|
1322 Klabzuba Avenue Prague OK 74864 | |
| (405) 567-4922 | |
| (405) 567-4290 |
| Full Name | Prague Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1322 Klabzuba Avenue, Prague, Oklahoma |
| Authorized Official Name and Position | Dianne M Dyer (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 4055674922 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prague Family Clinic Po Drawer S 1322 Klabzuba Avenue Prague OK 74864-1090 Ph: (405) 567-4922 | Prague Family Clinic 1322 Klabzuba Avenue Prague OK 74864 Ph: (405) 567-4922 |
| NPI Number | 1881923290 |
|---|---|
| Provider Enumeration Date | 12/14/2009 |
| Last Update Date | 03/09/2021 |
| Medicare PECOS PAC ID | 8123435187 |
|---|---|
| Medicare Enrollment ID | O20210324000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881923290 | NPI | - | NPPES |
| 200231400C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 2164 (Oklahoma) | Primary |
Rose Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3204 Nbu, 1022 W Main St, Prague, OK 74864 Phone: 405-567-1169 | |
Prague Healthcare Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 9th St, Prague, OK 74864 Phone: 405-566-3411 Fax: 405-566-3410 | |
Prague Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1322 Klabzuba, Prague, OK 74864 Phone: 405-567-2295 Fax: 405-567-4905 |