Tahlequah Family Practice | |
1500 E Downing St Suite 101 Tahlequah OK 74464-3234 | |
(918) 708-3570 | |
(918) 453-2772 |
Full Name | Tahlequah Family Practice |
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Speciality | Clinic/Center |
Location | 1500 E Downing St, Tahlequah, Oklahoma |
Authorized Official Name and Position | Scott Rosenthal (CEO) |
Authorized Official Contact | 9187723390 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tahlequah Family Practice Po Box 751 Hulbert OK 74441-0751 Ph: (918) 772-3390 | Tahlequah Family Practice 1500 E Downing St Suite 101 Tahlequah OK 74464-3234 Ph: (918) 708-3570 |
NPI Number | 1972052983 |
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Provider Enumeration Date | 10/03/2016 |
Last Update Date | 06/09/2020 |
Medicare PECOS PAC ID | 3678482635 |
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Medicare Enrollment ID | O20161031000894 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972052983 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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