| Clay Warren, | |
|
1001 N Country Club Rd, Ada, OK 74820-2847 | |
| (580) 421-4570 | |
| (580) 421-6283 |
| Full Name | Clay Warren |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine & Rehabilitation |
| Location | 1001 N Country Club Rd, Ada, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023198165 | NPI | - | NPPES |
| PT3927 | Other | OK | OK LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | PT3927 (Oklahoma) | Primary |
| Entity Name | Summit Rehab Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447480082 PECOS PAC ID: 4486794591 Enrollment ID: O20091222000314 |
| Mailing Address | Practice Location Address |
|---|---|
| Clay Warren, 1001 N Country Club Rd, Ada, OK 74820-2847 Ph: (580) 421-4570 | Clay Warren, 1001 N Country Club Rd, Ada, OK 74820-2847 Ph: (580) 421-4570 |
Jackie Mcdaniel, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1001 N Country Club Rd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-421-6283 | |
Lesli Barrett, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1001 N Country Club Rd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-436-2675 | |
Jamie Mose, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1001 N Country Club Rd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-421-6283 | |
Britt Johnson, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1001 N Country Club Rd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-421-6283 |