Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 901 W Main St, Durant, 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: () - | 901 W Main St Durant OK 74701-5070 Ph: (580) 634-2931 |
NPI Number | 1447820295 |
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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 | O20220223001585 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447820295 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
My Family Healthcare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1004 N 19th Ave Bldg 2, Durant, OK 74701 Phone: 580-924-5622 Fax: 580-745-5060 | |
Jaiswal Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 702 Bryan Dr, Suite 100, Durant, OK 74701 Phone: 580-924-4704 Fax: 580-924-6001 |