| Wyandotte Nation | |
|
1 Turtle Drive Wyandotte OK 74370 | |
| (918) 678-2282 | |
| (918) 678-2759 |
| Full Name | Wyandotte Nation |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Turtle Drive, Wyandotte, Oklahoma |
| Authorized Official Name and Position | Kelly Friend (HEALTH DIRECTOR) |
| Authorized Official Contact | 9186782282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyandotte Nation 1 Turtle Drive Wyandotte OK 74370 Ph: (918) 678-2282 | Wyandotte Nation 1 Turtle Drive Wyandotte OK 74370 Ph: (918) 678-2282 |
| NPI Number | 1124185517 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 09/06/2022 |
| Medicare PECOS PAC ID | 6406748367 |
|---|---|
| Medicare Enrollment ID | O20150923000516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124185517 | NPI | - | NPPES |
| 100707880A | Medicaid | OK | |
| 100732740B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Community Health Center Of Southeast Kansas, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7 S 1st St, Wyandotte, OK 74370 Phone: 620-231-9873 |