| Southbrook Family Physicians Pllc | |
|
8803 S. 101st E. Ave. Suite #130 Tulsa OK 74133-5728 | |
| (918) 459-0027 | |
| (918) 250-0457 |
| Full Name | Southbrook Family Physicians Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 8803 S. 101st E. Ave., Tulsa, Oklahoma |
| Authorized Official Name and Position | James R Beymer (PHYSICIAN) |
| Authorized Official Contact | 9184590027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southbrook Family Physicians Pllc 8803 S. 101st E. Ave. Suite #130 Tulsa OK 74133-5728 Ph: (918) 459-0027 | Southbrook Family Physicians Pllc 8803 S. 101st E. Ave. Suite #130 Tulsa OK 74133-5728 Ph: (918) 459-0027 |
| NPI Number | 1871686428 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 05/06/2009 |
| Medicare PECOS PAC ID | 1850440264 |
|---|---|
| Medicare Enrollment ID | O20090514000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871686428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Clell W Pond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093795510 PECOS PAC ID: 5890848543 Enrollment ID: I20090729000227 |
| Provider Name | Joel A Adkisson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861468548 PECOS PAC ID: 0840354957 Enrollment ID: I20091119000668 |
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