| Kickapoo Tribal Health Center | |
|
105365 S. Hwy 102 Building M Mcloud OK 74851 | |
| (405) 964-2081 | |
| (405) 964-2053 |
| Full Name | Kickapoo Tribal Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 105365 S. Hwy 102, Mcloud, Oklahoma |
| Authorized Official Name and Position | Janetta Mahtapene (HEALTH DIRECTOR) |
| Authorized Official Contact | 4059642081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kickapoo Tribal Health Center Po Box 1360 Mcloud OK 74851-1360 Ph: (405) 964-2081 | Kickapoo Tribal Health Center 105365 S. Hwy 102 Building M Mcloud OK 74851 Ph: (405) 964-2081 |
| NPI Number | 1265518203 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 11/02/2011 |
| Medicare PECOS PAC ID | 6800706037 |
|---|---|
| Medicare Enrollment ID | O20080523000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265518203 | NPI | - | NPPES |
| 100700140A | Medicaid | OK |
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