| Concordia Life Plan Community | |
|
7707 W Britton Rd Oklahoma City OK 73132-1512 | |
| (405) 720-7200 | |
| (405) 621-8701 |
| Full Name | Concordia Life Plan Community |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 7707 W Britton Rd, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Daniel Eischen (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 4057207200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Concordia Life Plan Community 7707 W Britton Rd Oklahoma City OK 73132-1512 Ph: (405) 720-7200 | Concordia Life Plan Community 7707 W Britton Rd Oklahoma City OK 73132-1512 Ph: (405) 720-7200 |
| NPI Number | 1043814023 |
|---|---|
| Provider Enumeration Date | 11/30/2020 |
| Last Update Date | 11/30/2020 |
| Medicare PECOS PAC ID | 7416026802 |
|---|---|
| Medicare Enrollment ID | O20210114002526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043814023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Courtney W Hammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992938450 PECOS PAC ID: 1355488669 Enrollment ID: I20091019000535 |
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