| Okmulgee Pediatrics & Family Care, L.l.p. | |
|
916 E 8th St Okmulgee OK 74447-4724 | |
| (918) 756-8371 | |
| (918) 758-3437 |
| Full Name | Okmulgee Pediatrics & Family Care, L.l.p. |
|---|---|
| Speciality | Pediatrics |
| Location | 916 E 8th St, Okmulgee, Oklahoma |
| Authorized Official Name and Position | Karen Renee Wilson (OFFICE MANAGER) |
| Authorized Official Contact | 9187568371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Okmulgee Pediatrics & Family Care, L.l.p. 916 E 8th St Okmulgee OK 74447-4724 Ph: (918) 756-8371 | Okmulgee Pediatrics & Family Care, L.l.p. 916 E 8th St Okmulgee OK 74447-4724 Ph: (918) 756-8371 |
| NPI Number | 1336221688 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 2961883608 |
|---|---|
| Medicare Enrollment ID | O20220713001013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336221688 | NPI | - | NPPES |
| 100708210B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
| Provider Name | Kiran Sibta Paul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225591142 PECOS PAC ID: 7911388665 Enrollment ID: I20220713001168 |
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