Triton Health Pllc | |
128 W. Main Street Vian OK 74962 | |
(918) 773-5228 | |
(918) 773-8482 |
Full Name | Triton Health Pllc |
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Speciality | Clinic/Center |
Location | 128 W. Main Street, Vian, Oklahoma |
Authorized Official Name and Position | Cary Patrick Sullivan (OWNER) |
Authorized Official Contact | 9187735228 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Triton Health Pllc Po Box 446 128 W. Main Street Vian OK 74962-0446 Ph: (918) 773-5228 | Triton Health Pllc 128 W. Main Street Vian OK 74962 Ph: (918) 773-5228 |
NPI Number | 1275945974 |
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Provider Enumeration Date | 05/29/2014 |
Last Update Date | 05/29/2014 |
Medicare PECOS PAC ID | 1951623214 |
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Medicare Enrollment ID | O20141124001108 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275945974 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 2148 (Oklahoma) | Primary |
Provider Name | Cary P Sullivan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497701130 PECOS PAC ID: 4688686637 Enrollment ID: I20060614000309 |
Provider Name | Ryan Sullivan |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1801029657 PECOS PAC ID: 4688710502 Enrollment ID: I20091007000369 |
Provider Name | Wanda Sue Choate |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356896856 PECOS PAC ID: 4587943279 Enrollment ID: I20161121001973 |
C. Patrick Sullivan,do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 North Thornton, Vian, OK 74962 Phone: 918-773-5228 Fax: 918-773-8482 | |
Osu-aj Triton Health, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 West Main, Vian, OK 74962 Phone: 918-773-5228 Fax: 918-773-8482 | |
Triton Health Elder Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 N Thornton St, Vian, OK 74962 Phone: 918-773-5228 |