| Midwest Medical Group Pllc | |
|
1201 S Douglas Blvd Suite J Midwest City OK 73130-5239 | |
| (405) 739-6840 | |
| (405) 732-7149 |
| Full Name | Midwest Medical Group Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1201 S Douglas Blvd, Midwest City, Oklahoma |
| Authorized Official Name and Position | Debbie Anderson (OFFICE MANAGER) |
| Authorized Official Contact | 4057396840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Medical Group Pllc 1201 S Douglas Blvd Suite J Midwest City OK 73130-5239 Ph: (405) 739-6840 | Midwest Medical Group Pllc 1201 S Douglas Blvd Suite J Midwest City OK 73130-5239 Ph: (405) 739-6840 |
| NPI Number | 1508842444 |
|---|---|
| Provider Enumeration Date | 12/22/2005 |
| Last Update Date | 12/11/2014 |
| Medicare PECOS PAC ID | 2365342672 |
|---|---|
| Medicare Enrollment ID | O20040112000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508842444 | NPI | - | NPPES |
| 100700490B | Medicaid | OK | |
| 375659300 | Other | OK | DEPT OF LABOR FECA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael T Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346226164 PECOS PAC ID: 3779483995 Enrollment ID: I20100922000427 |
| Provider Name | Tanner E Mcdaniel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669458451 PECOS PAC ID: 0042336315 Enrollment ID: I20100923000769 |
| Provider Name | Melvin D Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568448306 PECOS PAC ID: 8729151410 Enrollment ID: I20101109001007 |
| Provider Name | Aubrey A Kavanaugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487966313 PECOS PAC ID: 6709044092 Enrollment ID: I20120215000683 |
| Provider Name | Joshua S Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245671908 PECOS PAC ID: 2567683535 Enrollment ID: I20150122001021 |
Grace Mata Ruidera, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8121 National Ave, Suite 309, Midwest City, OK 73110 Phone: 405-732-3990 | |
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Mid-del Family Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 S Douglas Blvd, Midwest City, OK 73130 Phone: 405-736-6811 Fax: 405-736-6863 | |
Avenstar Pain Specialists, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1732 S Sooner Rd, Midwest City, OK 73110 Phone: 405-438-0913 | |
Midwest City Hma Physician Management, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Post Rd, Suite A, Midwest City, OK 73130 Phone: 405-732-3500 Fax: 405-732-3503 | |
Midway Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 351 N Air Depot Blvd, Suite Bb, Midwest City, OK 73110 Phone: 405-610-3600 Fax: 405-610-3607 | |
P David Margolis Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8121 National Ave, Suite 300, Midwest City, OK 73110 Phone: 405-737-9820 Fax: 405-733-0779 |