| Douglas Menz, D.o. P.c. | |
|
20912 Se 29th St Harrah OK 73045-6439 | |
| (405) 391-2970 | |
| (405) 391-2972 |
| Full Name | Douglas Menz, D.o. P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 20912 Se 29th St, Harrah, Oklahoma |
| Authorized Official Name and Position | George Douglas Menz (PHYSICIAN/OWNER) |
| Authorized Official Contact | 4053912970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas Menz, D.o. P.c. 20912 Se 29th St Harrah OK 73045-6439 Ph: (405) 391-2970 | Douglas Menz, D.o. P.c. 20912 Se 29th St Harrah OK 73045-6439 Ph: (405) 391-2970 |
| NPI Number | 1992996789 |
|---|---|
| Provider Enumeration Date | 08/06/2007 |
| Last Update Date | 08/19/2008 |
| Medicare PECOS PAC ID | 5092843821 |
|---|---|
| Medicare Enrollment ID | O20100514000284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992996789 | NPI | - | NPPES |
| 800522008 | Other | OK | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3408 (Oklahoma) | Primary |
| Provider Name | George D Menz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518977628 PECOS PAC ID: 8820126667 Enrollment ID: I20100525000015 |
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