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40 Hospital Rd Fairfax OK 74637-5084 | |
(918) 642-8827 | |
(918) 642-3298 |
Full Name | |
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Speciality | Clinic/Center |
Location | 40 Hospital Rd, Fairfax, Oklahoma |
Authorized Official Name and Position | Elizabeth J Pusey (PRESIDENT) |
Authorized Official Contact | 9496452321 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2524 N Broadway Edmond OK 73034-4172 Ph: (949) 322-4337 | 40 Hospital Rd Fairfax OK 74637-5084 Ph: (918) 642-8827 |
NPI Number | 1790314466 |
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Provider Enumeration Date | 04/05/2020 |
Last Update Date | 10/21/2024 |
Medicare PECOS PAC ID | 3678904752 |
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Medicare Enrollment ID | O20200511001103 |
Identifier | Type | State | Issuer |
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1790314466 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |