| Fairfax Medical Facilities, Inc. | |
|
122 E Grand Ave Ponca City OK 74601-5205 | |
| (580) 203-8270 | |
| Not Available |
| Full Name | Fairfax Medical Facilities, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 122 E Grand Ave, Ponca City, Oklahoma |
| Authorized Official Name and Position | Karen Cecelia Mcconnell (CEO) |
| Authorized Official Contact | 9186423100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Medical Facilities, Inc. 212 N Main St Fairfax OK 74637-3023 Ph: (918) 642-3100 | Fairfax Medical Facilities, Inc. 122 E Grand Ave Ponca City OK 74601-5205 Ph: (580) 203-8270 |
| NPI Number | 1316747017 |
|---|---|
| Provider Enumeration Date | 03/13/2025 |
| Last Update Date | 03/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316747017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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