| Jay Family Medicine Clinic | |
|
2485 N Main Street Jay OK 74346-0987 | |
| (918) 253-2550 | |
| (918) 253-2559 |
| Full Name | Jay Family Medicine Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 2485 N Main Street, Jay, Oklahoma |
| Authorized Official Name and Position | Richard H Tidwell (OWNER) |
| Authorized Official Contact | 9182532550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay Family Medicine Clinic Po Box 987 Jay OK 74346-0987 Ph: (918) 253-2550 | Jay Family Medicine Clinic 2485 N Main Street Jay OK 74346-0987 Ph: (918) 253-2550 |
| NPI Number | 1366589608 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366589608 | NPI | - | NPPES |
| 442760537004 | Other | OK | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 18708 (Oklahoma) | Primary |
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