| Mccurtain Family Medical Clinic | |
|
110 W 1st St Broken Bow OK 74728-3902 | |
| (580) 584-7210 | |
| (580) 584-7213 |
| Full Name | Mccurtain Family Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 110 W 1st St, Broken Bow, Oklahoma |
| Authorized Official Name and Position | Monty J Mcgrugan (PHYSICIAN) |
| Authorized Official Contact | 5805847210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mccurtain Family Medical Clinic 800 N Park Dr Broken Bow OK 74728-2146 Ph: (580) 584-7210 | Mccurtain Family Medical Clinic 110 W 1st St Broken Bow OK 74728-3902 Ph: (580) 584-7210 |
| NPI Number | 1588876973 |
|---|---|
| Provider Enumeration Date | 05/05/2007 |
| Last Update Date | 02/16/2024 |
| Medicare PECOS PAC ID | 3476651514 |
|---|---|
| Medicare Enrollment ID | O20070613000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588876973 | NPI | - | NPPES |
| 200015540C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Terry J Draper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942793351 PECOS PAC ID: 1355354481 Enrollment ID: I20180828000542 |
| Provider Name | Lauren Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477093557 PECOS PAC ID: 1153750492 Enrollment ID: I20200508000064 |
| Provider Name | Jennifer Ann Christian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649896580 PECOS PAC ID: 6709204290 Enrollment ID: I20200915003241 |
| Provider Name | Rhonda Jo Deramus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174121248 PECOS PAC ID: 7719391820 Enrollment ID: I20210202000742 |
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