| Fairview Regional Medical Center Authority | |
|
519 E State Rd Fairview OK 73737-1458 | |
| (580) 227-2585 | |
| (580) 227-2882 |
| Full Name | Fairview Regional Medical Center Authority |
|---|---|
| Speciality | Family Medicine |
| Location | 519 E State Rd, Fairview, Oklahoma |
| Authorized Official Name and Position | Roger Knak (ADMINISTRATOR) |
| Authorized Official Contact | 5802273721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairview Regional Medical Center Authority Po Box 548 Fairview OK 73737-0548 Ph: (580) 227-2585 | Fairview Regional Medical Center Authority 519 E State Rd Fairview OK 73737-1458 Ph: (580) 227-2585 |
| NPI Number | 1316981657 |
|---|---|
| Provider Enumeration Date | 06/16/2006 |
| Last Update Date | 03/11/2015 |
| Medicare PECOS PAC ID | 4183943186 |
|---|---|
| Medicare Enrollment ID | O20150501000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316981657 | NPI | - | NPPES |
| 100700800C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John Stephen Price |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376560904 PECOS PAC ID: 6002702040 Enrollment ID: I20040225001132 |
| Provider Name | John A Hensley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841252483 PECOS PAC ID: 7416947882 Enrollment ID: I20040517000951 |
| Provider Name | Donald R Klinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437185667 PECOS PAC ID: 0244224368 Enrollment ID: I20060203000161 |
| Provider Name | Solomon Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588666010 PECOS PAC ID: 4082745765 Enrollment ID: I20100624000019 |
| Provider Name | Elizabeth A Kimball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225465768 PECOS PAC ID: 9133420896 Enrollment ID: I20151222001883 |
| Provider Name | Megan L Ewing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598212664 PECOS PAC ID: 2961783196 Enrollment ID: I20170103000049 |
| Provider Name | Larry S Elliott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770933277 PECOS PAC ID: 1153659875 Enrollment ID: I20190820001052 |
Fairview Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 519 E State Rd, Fairview, OK 73737 Phone: 580-227-2585 Fax: 580-227-1382 | |
Fairview Regional Medical Center Authority Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 519 E State Rd, Fairview, OK 73737 Phone: 580-227-3721 Fax: 580-227-2882 | |
Entrust Dpc Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 917 N Main St, Fairview, OK 73737 Phone: 580-227-8647 Fax: 580-603-8602 |