| Triad Complete Healthcare | |
|
4151 N Harrison Shawnee OK 74804 | |
| (405) 613-9720 | |
| Not Available |
| Full Name | Triad Complete Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 4151 N Harrison, Shawnee, Oklahoma |
| Authorized Official Name and Position | Eric Winegardner (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4056139720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Triad Complete Healthcare 20228 Red Oak Ct Tecumseh OK 74873-7131 Ph: (405) 613-9720 | Triad Complete Healthcare 4151 N Harrison Shawnee OK 74804 Ph: (405) 613-9720 |
| NPI Number | 1528749041 |
|---|---|
| Provider Enumeration Date | 07/27/2023 |
| Last Update Date | 02/05/2024 |
| Medicare PECOS PAC ID | 1759726433 |
|---|---|
| Medicare Enrollment ID | O20240304003658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528749041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shelby Janae Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700351392 PECOS PAC ID: 3375920093 Enrollment ID: I20220519000608 |
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