| Deer Creek Family Healthcare And Wellness Clinic Llc | |
|
19401 N. Portland Edmond OK 73012 | |
| (405) 812-8208 | |
| Not Available |
| Full Name | Deer Creek Family Healthcare And Wellness Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19401 N. Portland, Edmond, Oklahoma |
| Authorized Official Name and Position | Kim Knox (NURSE PRACTITIONER / OWNER) |
| Authorized Official Contact | 4058128208 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deer Creek Family Healthcare And Wellness Clinic Llc 19401 N. Portland Edmond OK 73012 Ph: (405) 812-8208 | Deer Creek Family Healthcare And Wellness Clinic Llc 19401 N. Portland Edmond OK 73012 Ph: (405) 812-8208 |
| NPI Number | 1003227414 |
|---|---|
| Provider Enumeration Date | 05/20/2014 |
| Last Update Date | 06/27/2014 |
| Medicare PECOS PAC ID | 6709007099 |
|---|---|
| Medicare Enrollment ID | O20141030001805 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003227414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kim B Knox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871554808 PECOS PAC ID: 8921077215 Enrollment ID: I20041004000142 |
| Provider Name | David R Allen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154398410 PECOS PAC ID: 6002976594 Enrollment ID: I20081113000269 |
| Provider Name | Kimberly A Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932340478 PECOS PAC ID: 8729242656 Enrollment ID: I20120605000727 |
| Provider Name | Nana B Tetteh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346809894 PECOS PAC ID: 7214262252 Enrollment ID: I20190712000207 |
| Provider Name | Genevieve K Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821654260 PECOS PAC ID: 0840527735 Enrollment ID: I20190815001454 |
| Provider Name | Kimberly Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629773155 PECOS PAC ID: 7810354362 Enrollment ID: I20230530000013 |
Nathan Valentine, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2308 Nw 158th St, Edmond, OK 73013 Phone: 405-887-6515 Fax: 866-707-6724 | |
Mark R Lynn Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 S Bryant Ave, Suite 204a, Edmond, OK 73034 Phone: 405-359-3637 Fax: 405-359-2022 | |
Ali Nawaz Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2940 Hunter Crest Dr, Edmond, OK 73034 Phone: 917-558-4195 | |
Saint Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 416 W 15th St, Edmond, OK 73013 Phone: 405-513-8535 | |
Edmond Podiatry Associates Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 105 S Bryant Ave Ste 104, Edmond, OK 73034 Phone: 405-715-3102 Fax: 405-715-2905 | |
American Current Care P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3406 S Boulevard, Edmond, OK 73013 Phone: 405-230-9700 Fax: 405-230-9711 |