Beth Lane, SLP | |
105 N 5th Ave, Madill, OK 73446-1203 | |
(580) 795-3301 | |
(580) 795-7307 |
Full Name | Beth Lane |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 105 N 5th Ave, Madill, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841302130 | NPI | - | NPPES |
100641040D | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 1030 (Oklahoma) | Primary |
Provider Name | Board Of Regents Of The University Of Oklahoma - Allied Health Clinics |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1740389626 PECOS PAC ID: 0840288007 Enrollment ID: O20040505000761 |
Mailing Address | Practice Location Address |
---|---|
Beth Lane, SLP Po Box 831, Madill, OK 73446-0831 Ph: (580) 795-3301 | Beth Lane, SLP 105 N 5th Ave, Madill, OK 73446-1203 Ph: (580) 795-3301 |
Susan Mathis Grogan, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 105 N 5th Ave, Madill, OK 73446 Phone: 580-795-3301 Fax: 580-795-7307 | |
Jennifer Dawn Pitman, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 105 N 5th Ave, Madill, OK 73446 Phone: 580-795-3301 Fax: 580-795-7307 | |
Deborah Leah Self, M.S.,C.C.C. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 601 W Mcarthur St, Madill, OK 73446 Phone: 580-795-3680 |