| Premier Primary Care | |
|
1109 E Cherokee Ave Sallisaw OK 74955-5035 | |
| (918) 790-3309 | |
| (918) 775-0587 |
| Full Name | Premier Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 1109 E Cherokee Ave, Sallisaw, Oklahoma |
| Authorized Official Name and Position | Christopher W Orendorff (OWNER) |
| Authorized Official Contact | 9187903309 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Primary Care 1109 E Cherokee Ave Sallisaw OK 74955-5035 Ph: (405) 307-6668 | Premier Primary Care 1109 E Cherokee Ave Sallisaw OK 74955-5035 Ph: (918) 790-3309 |
| NPI Number | 1548642333 |
|---|---|
| Provider Enumeration Date | 06/29/2015 |
| Last Update Date | 09/29/2021 |
| Medicare PECOS PAC ID | 2961717426 |
|---|---|
| Medicare Enrollment ID | O20150813010157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548642333 | NPI | - | NPPES |
| 2004757430B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Christopher W Orendorff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922233618 PECOS PAC ID: 0648468405 Enrollment ID: I20101220001211 |
| Provider Name | Michelle L Stapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619381902 PECOS PAC ID: 8325268675 Enrollment ID: I20141008001595 |
| Provider Name | Audra A O'dell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376020420 PECOS PAC ID: 0244589604 Enrollment ID: I20180817000389 |
| Provider Name | Amber Dawn Mahar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982203444 PECOS PAC ID: 7810302304 Enrollment ID: I20210216000031 |
| Provider Name | Stephanie Megan Choate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720570609 PECOS PAC ID: 4183975733 Enrollment ID: I20231020001147 |
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