| Southeastern Pediatrics And Family Practice | |
|
1705 N Washington Ave Ste C Durant OK 74701-2100 | |
| (580) 924-5439 | |
| Not Available |
| Full Name | Southeastern Pediatrics And Family Practice |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1705 N Washington Ave Ste C, Durant, Oklahoma |
| Authorized Official Name and Position | Myna Laughlin (OWNER) |
| Authorized Official Contact | 5809245439 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Pediatrics And Family Practice 1705 N Washington Ave Ste C Durant OK 74701-2100 Ph: () - | Southeastern Pediatrics And Family Practice 1705 N Washington Ave Ste C Durant OK 74701-2100 Ph: (580) 924-5439 |
| NPI Number | 1477210516 |
|---|---|
| Provider Enumeration Date | 11/23/2021 |
| Last Update Date | 10/17/2022 |
| Medicare PECOS PAC ID | 9335530419 |
|---|---|
| Medicare Enrollment ID | O20211228001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477210516 | NPI | - | NPPES |
| Provider Name | David M Lovelace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326087800 PECOS PAC ID: 4385699008 Enrollment ID: I20050316000033 |
| Provider Name | Myna R Laughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366515389 PECOS PAC ID: 9335226240 Enrollment ID: I20091027000731 |
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