| Fairview Regional Medical Center Authority | |
|
519 E State Rd Fairview OK 73737-1458 | |
| (580) 227-3721 | |
| (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) 227-3721 | Fairview Regional Medical Center Authority 519 E State Rd Fairview OK 73737-1458 Ph: (580) 227-3721 |
| NPI Number | 1356379309 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 04/23/2015 |
| Medicare PECOS PAC ID | 4183943186 |
|---|---|
| Medicare Enrollment ID | O20150424000154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356379309 | NPI | - | NPPES |
| 100700800E | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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: 580-227-2585 Fax: 580-227-2882 | |
Entrust Dpc Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1425 N Main St Ste 1, Fairview, OK 73737 Phone: 580-227-8647 Fax: 580-603-8602 |