| Sharrock Medical Llc | |
|
1401 S Lynn Ln Idabel OK 74745-6859 | |
| (870) 279-3300 | |
| Not Available |
| Full Name | Sharrock Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1401 S Lynn Ln, Idabel, Oklahoma |
| Authorized Official Name and Position | Hollie Elizabeth Sharrock (OWNER) |
| Authorized Official Contact | 5802457044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sharrock Medical Llc 1401 S Lynn Ln Idabel OK 74745-6859 Ph: (870) 279-3300 | Sharrock Medical Llc 1401 S Lynn Ln Idabel OK 74745-6859 Ph: (870) 279-3300 |
| NPI Number | 1740921014 |
|---|---|
| Provider Enumeration Date | 04/02/2022 |
| Last Update Date | 09/06/2022 |
| Medicare PECOS PAC ID | 7618359274 |
|---|---|
| Medicare Enrollment ID | O20220729001425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740921014 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Hollie Sharrock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144984238 PECOS PAC ID: 8527440189 Enrollment ID: I20220729001570 |
| Provider Name | Hollie Sharrock |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1144984238 PECOS PAC ID: 8527440189 Enrollment ID: I20231121003951 |
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