| Larry Shane Elliott, | |
|
523 E State Rd, Fairview, OK 73737-1453 | |
| (580) 227-3721 | |
| (580) 227-2882 |
| Full Name | Larry Shane Elliott |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 9 Years |
| Location | 523 E State Rd, Fairview, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770933277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 6155 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Norman Regional | Norman, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Norman Regional Providers Primary Care | 5496837718 | 56 |
| Entity Name | Norman Regional Providers Primary Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548398274 PECOS PAC ID: 5496837718 Enrollment ID: O20080125000271 |
| Entity Name | Fairview Regional Medical Center Authority |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1033153309 PECOS PAC ID: 4183943186 Enrollment ID: O20150424001440 |
| Entity Name | Fairview Regional Medical Center Authority |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1053357210 PECOS PAC ID: 4183943186 Enrollment ID: O20150424001584 |
| Entity Name | Fairview Regional Medical Center Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316981657 PECOS PAC ID: 4183943186 Enrollment ID: O20150501000163 |
| Entity Name | Your Health Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396385431 PECOS PAC ID: 3870922008 Enrollment ID: O20200408004584 |
| Mailing Address | Practice Location Address |
|---|---|
| Larry Shane Elliott, 523 E State Rd, Fairview, OK 73737-1453 Ph: (580) 227-3721 | Larry Shane Elliott, 523 E State Rd, Fairview, OK 73737-1453 Ph: (580) 227-3721 |
Andrea Ellen Mceachern, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 917 N Main St, Fairview, OK 73737 Phone: 580-227-8647 Fax: 580-603-8602 | |
Donald Klinger, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 519 E State Rd, Fairview, OK 73737 Phone: 580-227-2585 Fax: 580-227-2882 |