| Skiatook Family Clinic | |
|
201 E 2nd St Skiatook OK 74070-1211 | |
| (918) 396-1262 | |
| (918) 396-4598 |
| Full Name | Skiatook Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 E 2nd St, Skiatook, Oklahoma |
| Authorized Official Name and Position | Layne E Subera (OWNER) |
| Authorized Official Contact | 9183961262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Skiatook Family Clinic 201 E 2nd St Skiatook OK 74070-1211 Ph: (918) 396-1262 | Skiatook Family Clinic 201 E 2nd St Skiatook OK 74070-1211 Ph: (918) 396-1262 |
| NPI Number | 1811366032 |
|---|---|
| Provider Enumeration Date | 09/17/2015 |
| Last Update Date | 07/14/2023 |
| Medicare PECOS PAC ID | 3072810738 |
|---|---|
| Medicare Enrollment ID | O20160323000792 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811366032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3385 (Oklahoma) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Layne E Subera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568483758 PECOS PAC ID: 9931391786 Enrollment ID: I20101012000442 |
| Provider Name | Jamie Lynn Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982137055 PECOS PAC ID: 7113291741 Enrollment ID: I20170921000105 |
| Provider Name | Brooke R Ostberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982160248 PECOS PAC ID: 8022359215 Enrollment ID: I20190417000672 |
Skiatook Osteopathic Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E 2nd St, Pob 428, Skiatook, OK 74070 Phone: 918-396-1262 Fax: 918-396-4598 |