| Janet Fanning, MD PC | |
|
416 Sw 79th St Ste 100 Oklahoma City OK 73139 | |
| (405) 702-4777 | |
| (405) 770-4770 |
| Full Name | Janet Fanning, MD PC |
|---|---|
| Speciality | Family Medicine |
| Location | 416 Sw 79th St Ste 100, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Janet Fanning (OWNER) |
| Authorized Official Contact | 4056295343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Janet Fanning, MD PC 416 Sw 79th St Ste 100 Oklahoma City OK 73139-8121 Ph: (405) 702-4777 | Janet Fanning, MD PC 416 Sw 79th St Ste 100 Oklahoma City OK 73139 Ph: (405) 702-4777 |
| NPI Number | 1437570223 |
|---|---|
| Provider Enumeration Date | 12/20/2013 |
| Last Update Date | 11/30/2018 |
| Medicare PECOS PAC ID | 0840410940 |
|---|---|
| Medicare Enrollment ID | O20141010002255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437570223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Anita Louise Tanner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346206331 PECOS PAC ID: 6406842285 Enrollment ID: I20040426000660 |
| Provider Name | Janet L Fanning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396786737 PECOS PAC ID: 5092772509 Enrollment ID: I20041216000461 |
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