| Gary Vancil, | |
|
2202 N Broadway St, Poteau, OK 74953-2000 | |
| (918) 649-0018 | |
| Not Available |
| Full Name | Gary Vancil |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 2202 N Broadway St, Poteau, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013506815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Entity Name | Millennium Medical Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245286285 PECOS PAC ID: 6204730856 Enrollment ID: O20040105000859 |
| Entity Name | New Hope Counseling And Guidance Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457991770 PECOS PAC ID: 6608272562 Enrollment ID: O20210901002431 |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Vancil, 2202 N Broadway St, Poteau, OK 74953-2000 Ph: (918) 649-0018 | Gary Vancil, 2202 N Broadway St, Poteau, OK 74953-2000 Ph: (918) 649-0018 |
Taylar Gorgas, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1120 Tarby Rd, Poteau, OK 74953 Phone: 800-640-9741 Fax: 918-647-4095 | |
Miranda Crase, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 804 S Broadway St, Poteau, OK 74953 Phone: 918-647-9629 Fax: 918-649-0136 |