Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 416 N Main St, Altus, Oklahoma |
Authorized Official Name and Position | Grant Asay (CEO) |
Authorized Official Contact | 4054451210 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
701 Cedar Lake Blvd Ste 120 Oklahoma City OK 73114-7815 Ph: (405) 445-1210 | 416 N Main St Altus OK 73521-3108 Ph: (580) 379-0325 |
NPI Number | 1063082808 |
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Provider Enumeration Date | 06/24/2021 |
Last Update Date | 02/24/2023 |
Medicare PECOS PAC ID | 3375832157 |
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Medicare Enrollment ID | O20210819003761 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063082808 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Altus Chiropractic Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 903 Falcon Rd, Altus, OK 73521 Phone: 580-482-4499 Fax: 580-482-4449 | |
Noble L Ballard.medical Clinic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1015 East Broadway Street, Stuite 101, Altus, OK 73521 Phone: 580-480-1900 Fax: 580-477-1936 | |