| Neighborhood Family Clinic & Minor | |
|
6102 Nw 63rd St Ste B Oklahoma City OK 73132-7526 | |
| (405) 373-2400 | |
| (405) 373-4400 |
| Full Name | Neighborhood Family Clinic & Minor |
|---|---|
| Speciality | Clinic/Center |
| Location | 6102 Nw 63rd St Ste B, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Antonia Pratt-reid (OWNER) |
| Authorized Official Contact | 4053732400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neighborhood Family Clinic & Minor Po Box 660 Piedmont OK 73078-0660 Ph: (405) 373-2400 | Neighborhood Family Clinic & Minor 6102 Nw 63rd St Ste B Oklahoma City OK 73132-7526 Ph: (405) 373-2400 |
| NPI Number | 1730304320 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 02/25/2016 |
| Medicare PECOS PAC ID | 9234136623 |
|---|---|
| Medicare Enrollment ID | O20061027000065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730304320 | NPI | - | NPPES |
| 200043440B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Antonia M Pratt-reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477595635 PECOS PAC ID: 9335136266 Enrollment ID: I20060707000138 |
| Provider Name | Michelle L Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316122039 PECOS PAC ID: 4880744549 Enrollment ID: I20090618000346 |
| Provider Name | Damarcus Rochoen Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194080499 PECOS PAC ID: 8123273877 Enrollment ID: I20130301000246 |
| Provider Name | Charles Pollard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497164396 PECOS PAC ID: 4183942683 Enrollment ID: I20150414000120 |
| Provider Name | Katherine M Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578113833 PECOS PAC ID: 5294158853 Enrollment ID: I20200715000662 |
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Board Of Regents Of The Univ Of Okla Ou Physicians Employer Spons Clin Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Robinson Ave, Suite 200, Oklahoma City, OK 73102 Phone: 405-271-8880 Fax: 405-208-8732 | |
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