Kent Alan Johnson, NP | |
716 S Highway 77, Newkirk, OK 74647-7009 | |
(580) 362-2555 | |
(580) 362-2948 |
Full Name | Kent Alan Johnson |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 716 S Highway 77, Newkirk, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437573508 | NPI | - | NPPES |
344359YRHZ | Other | OK | MEDICARE PTAN |
200528420A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 86602 (Oklahoma) | Primary |
Entity Name | Comanche County Healthcare Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053352690 PECOS PAC ID: 0749192433 Enrollment ID: O20031106000742 |
Entity Name | Jeffrey K Mcilroy Md Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053531830 PECOS PAC ID: 8527962216 Enrollment ID: O20031124000657 |
Entity Name | Oklahoma Mental Health Council |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275574907 PECOS PAC ID: 3173514387 Enrollment ID: O20040518001034 |
Entity Name | Fairfax Medical Facilities Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538183173 PECOS PAC ID: 4284663360 Enrollment ID: O20060209000250 |
Mailing Address | Practice Location Address |
---|---|
Kent Alan Johnson, NP 212 N Main St, Fairfax, OK 74637-3023 Ph: (918) 642-3100 | Kent Alan Johnson, NP 716 S Highway 77, Newkirk, OK 74647-7009 Ph: (580) 362-2555 |
Janae Miller, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3151 E River Rd, Newkirk, OK 74647 Phone: 580-362-1039 Fax: 580-362-1467 | |
Lela J. Goatley, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 716 S Highway 77, Newkirk, OK 74647 Phone: 580-362-2555 Fax: 580-362-2948 | |
Mary Tinsley, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3151 East River Road, Newkirk, OK 74647 Phone: 580-362-1039 Fax: 580-362-1039 |