| Family Medical Clinic | |
|
104 Wall St Poteau OK 74953-4405 | |
| (918) 647-8635 | |
| (918) 635-3191 |
| Full Name | Family Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 Wall St, Poteau, Oklahoma |
| Authorized Official Name and Position | Robert L Carter (CEO) |
| Authorized Official Contact | 9186353441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Clinic Po Box 689 Poteau OK 74953-0689 Ph: (918) 647-8635 | Family Medical Clinic 104 Wall St Poteau OK 74953-4405 Ph: (918) 647-8635 |
| NPI Number | 1043265895 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 07/05/2019 |
| Medicare PECOS PAC ID | 7719916956 |
|---|---|
| Medicare Enrollment ID | O20060804000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043265895 | NPI | - | NPPES |
| 100700730I | Medicaid | OK | |
| 373479 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208600000X | Surgery | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | 373479 (Oklahoma) | Primary |
| Provider Name | Janet L Garvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952341562 PECOS PAC ID: 9335144716 Enrollment ID: I20060918000190 |
| Provider Name | Nancy Merritt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992843809 PECOS PAC ID: 3274687207 Enrollment ID: I20090811000054 |
| Provider Name | Dennis J Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336102532 PECOS PAC ID: 9739098963 Enrollment ID: I20100510000648 |
| Provider Name | Linda M Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982948287 PECOS PAC ID: 2365337243 Enrollment ID: I20130716000506 |
| Provider Name | Jawad M Trad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669770145 PECOS PAC ID: 5092946855 Enrollment ID: I20140320002097 |
| Provider Name | Beth E Hites |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154628113 PECOS PAC ID: 9830310135 Enrollment ID: I20141030002033 |
| Provider Name | Karen A Clark |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174593727 PECOS PAC ID: 6608789474 Enrollment ID: I20150224001388 |
| Provider Name | Zbigniew T Beyga |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699743831 PECOS PAC ID: 1658277819 Enrollment ID: I20160511000357 |
| Provider Name | Edward Chester Wemmerus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952757254 PECOS PAC ID: 0345532347 Enrollment ID: I20160712002686 |
| Provider Name | Crystal Ollie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396248381 PECOS PAC ID: 8426313990 Enrollment ID: I20180604002256 |
| Provider Name | Krystel Lynne Huddleston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700361490 PECOS PAC ID: 0749527075 Enrollment ID: I20190124002707 |
| Provider Name | Tiffany B Griffis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699215228 PECOS PAC ID: 7911290267 Enrollment ID: I20190729003067 |
| Provider Name | Rachel Michelle Place |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376182816 PECOS PAC ID: 3870922065 Enrollment ID: I20200409002182 |
| Provider Name | Delaina Larae Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912536269 PECOS PAC ID: 7719301761 Enrollment ID: I20200723000075 |
| Provider Name | Mark Mayfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376567081 PECOS PAC ID: 6204920945 Enrollment ID: I20211006002957 |
| Provider Name | Danni M Welch |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427289131 PECOS PAC ID: 1153476221 Enrollment ID: I20211025000527 |
| Provider Name | Cynthia Renee Leatherwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346993441 PECOS PAC ID: 5092109702 Enrollment ID: I20220223000753 |
| Provider Name | Vivian Mo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639196363 PECOS PAC ID: 5294823191 Enrollment ID: I20230118001497 |
| Provider Name | Ambreen Mohamed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437443637 PECOS PAC ID: 4183944788 Enrollment ID: I20230314002700 |
| Provider Name | Jonathan Allen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922186402 PECOS PAC ID: 4284734518 Enrollment ID: I20230315002246 |
| Provider Name | Pei-chun Mcgregor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023231073 PECOS PAC ID: 5890919906 Enrollment ID: I20230316000524 |
| Provider Name | Amy Joyce Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154776409 PECOS PAC ID: 5890029953 Enrollment ID: I20231204002618 |
| Provider Name | Bernard Michael Tougas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366434680 PECOS PAC ID: 1951322635 Enrollment ID: I20240109002585 |
River Valley Primary Care Of Poteau, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 Dewey Ave, Poteau, OK 74953 Phone: 504-495-6772 | |
Dennis J Carter Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1013 Dewey Ave, Poteau, OK 74953 Phone: 918-647-2929 Fax: 918-647-2288 | |
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Huddleston Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1001 N Broadway St, Poteau, OK 74953 Phone: 918-649-0731 | |
Pro-care Family Health Of Oklahoma , Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1103 Dewey Ave, Poteau, OK 74953 Phone: 918-647-0670 Fax: 918-647-0460 | |
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