| Mercy Health Love County Rural Health Clinic | |
|
301 Wanda St Marietta OK 73448-1229 | |
| (580) 276-2400 | |
| (580) 276-4358 |
| Full Name | Mercy Health Love County Rural Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 Wanda St, Marietta, Oklahoma |
| Authorized Official Name and Position | W Scott Callender (ADMINISTRATOR) |
| Authorized Official Contact | 5802763347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Health Love County Rural Health Clinic 301 Wanda St Marietta OK 73448-1229 Ph: (580) 276-2400 | Mercy Health Love County Rural Health Clinic 301 Wanda St Marietta OK 73448-1229 Ph: (580) 276-2400 |
| NPI Number | 1881723013 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 04/12/2023 |
| Medicare PECOS PAC ID | 4880580950 |
|---|---|
| Medicare Enrollment ID | O20040225000703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881723013 | NPI | - | NPPES |
| 261QR1300X | Other | OK | TAXONOMY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Oklahoma) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Stephen Irving Hutchins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073564597 PECOS PAC ID: 8123142296 Enrollment ID: I20100825001061 |
| Provider Name | Patricia Christner Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871544338 PECOS PAC ID: 2668602046 Enrollment ID: I20140304001310 |
| Provider Name | Terry G Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942403670 PECOS PAC ID: 4981821816 Enrollment ID: I20140815001876 |
| Provider Name | Margaret Western |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811941149 PECOS PAC ID: 5890708051 Enrollment ID: I20150804004215 |
| Provider Name | Nikki Kristin Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316584253 PECOS PAC ID: 1850726696 Enrollment ID: I20200124000363 |
| Provider Name | Stacy Chemda Goode |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225248784 PECOS PAC ID: 1052497591 Enrollment ID: I20230929000877 |
Mercy Health Love County Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 301 Wanda St, Marietta, OK 73448 Phone: 580-276-2400 Fax: 580-276-4358 |