| Three C's Medical Clinic Inc | |
|
2526 W Edison St Tulsa OK 74127-6128 | |
| (918) 587-5100 | |
| Not Available |
| Full Name | Three C's Medical Clinic Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2526 W Edison St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Susanne P Thompson (CEO) |
| Authorized Official Contact | 9185875100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Three C's Medical Clinic Inc Po Box 27434 Tulsa OK 74149-0434 Ph: (918) 587-5100 | Three C's Medical Clinic Inc 2526 W Edison St Tulsa OK 74127-6128 Ph: (918) 587-5100 |
| NPI Number | 1780719153 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0446375208 |
|---|---|
| Medicare Enrollment ID | O20100916000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780719153 | NPI | - | NPPES |
| 10092790A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 3291 (Oklahoma) | Primary |
| Provider Name | Susanne P Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033111547 PECOS PAC ID: 7618093170 Enrollment ID: I20100922000542 |
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