| Previse Medical Llc | |
|
4701 Shades Bridge Rd Edmond OK 73034-0881 | |
| (405) 623-2498 | |
| Not Available |
| Full Name | Previse Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4701 Shades Bridge Rd, Edmond, Oklahoma |
| Authorized Official Name and Position | Alexander Frank (OWNER) |
| Authorized Official Contact | 4056232498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Previse Medical Llc 4701 Shades Bridge Rd Edmond OK 73034-0881 Ph: () - | Previse Medical Llc 4701 Shades Bridge Rd Edmond OK 73034-0881 Ph: (405) 623-2498 |
| NPI Number | 1699433961 |
|---|---|
| Provider Enumeration Date | 12/03/2021 |
| Last Update Date | 12/03/2021 |
| Medicare PECOS PAC ID | 4385036748 |
|---|---|
| Medicare Enrollment ID | O20220114000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699433961 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Alexander Frank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164450573 PECOS PAC ID: 4587624473 Enrollment ID: I20041014000961 |
| Provider Name | Nicole D Cornish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003296492 PECOS PAC ID: 2163737743 Enrollment ID: I20150811004527 |
| Provider Name | Katrina D Weston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578937009 PECOS PAC ID: 3870884638 Enrollment ID: I20160624002031 |
| Provider Name | Brent Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659869881 PECOS PAC ID: 6204266240 Enrollment ID: I20200415001931 |
| Provider Name | Daniel Tucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265923759 PECOS PAC ID: 9133475791 Enrollment ID: I20211208001989 |
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