| Complete & Comprehensive Kidney Care PLLC | |
|
810 Nw 10th St Ste A Oklahoma City OK 73106-7216 | |
| (405) 272-8367 | |
| Not Available |
| Full Name | Complete & Comprehensive Kidney Care PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 810 Nw 10th St Ste A, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Tariq a Khan (CEO) |
| Authorized Official Contact | 3146298948 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete & Comprehensive Kidney Care PLLC Po Box 268946 Oklahoma City OK 73126-8946 Ph: (405) 691-4703 | Complete & Comprehensive Kidney Care PLLC 810 Nw 10th St Ste A Oklahoma City OK 73106-7216 Ph: (405) 272-8367 |
| NPI Number | 1922647585 |
|---|---|
| Provider Enumeration Date | 12/31/2019 |
| Last Update Date | 12/31/2019 |
| Certification Date | 12/31/2019 |
| Medicare PECOS PAC ID | 3375979263 |
|---|---|
| Medicare Enrollment ID | O20200213000917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922647585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | () | Primary |
| Provider Name | Shannon Lea Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639166499 PECOS PAC ID: 0143203273 Enrollment ID: I20121026000250 |
| Provider Name | Tariq Asadullah Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396804662 PECOS PAC ID: 3870662182 Enrollment ID: I20181010000903 |
| Provider Name | Lauren D'ann Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821627167 PECOS PAC ID: 2668895178 Enrollment ID: I20200630003044 |
| Provider Name | Justin Paul Walke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174193981 PECOS PAC ID: 6305234576 Enrollment ID: I20211021001398 |
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American Current Care P.A. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7100 S I-35 Service Road, Suite 7, Oklahoma City, OK 73149 Phone: 405-632-1002 Fax: 405-632-3131 |
St Anthony Primary Care Physicians North Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6201 N Santa Fe Ave, Suite 2020, Oklahoma City, OK 73118 Phone: 405-272-5433 Fax: 405-272-5435 |
Oklahoma Pain & Rehab LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2149 Sw 59th St, Suite 201, Oklahoma City, OK 73119 Phone: 405-681-5800 |
Board of Regents of the Univ of Okla OU Physicians Employer Spons Clin Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Robinson Ave, Suite 200, Oklahoma City, OK 73102 Phone: 405-271-8880 Fax: 405-208-8732 |