Spillars Medical, P.c. | |
8803 S 101st East Ave Suite 295 Tulsa OK 74133-5726 | |
(918) 294-9865 | |
(918) 294-9866 |
Full Name | Spillars Medical, P.c. |
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Speciality | Clinic/Center |
Location | 8803 S 101st East Ave, Tulsa, Oklahoma |
Authorized Official Name and Position | Rodger Brannon Spillars (OWNER) |
Authorized Official Contact | 9182949865 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Spillars Medical, P.c. 8803 S 101st East Ave Suite 295 Tulsa OK 74133-5726 Ph: (918) 294-9865 | Spillars Medical, P.c. 8803 S 101st East Ave Suite 295 Tulsa OK 74133-5726 Ph: (918) 294-9865 |
NPI Number | 1487859237 |
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Provider Enumeration Date | 06/20/2007 |
Last Update Date | 06/22/2010 |
Medicare PECOS PAC ID | 9638361967 |
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Medicare Enrollment ID | O20101005001115 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487859237 | NPI | - | NPPES |
100132160C | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Rodger B Spillars |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1679508568 PECOS PAC ID: 6800935024 Enrollment ID: I20101005001166 |
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