| Restore Family Medical Clinic | |
|
416020 E 1951 Rd Antlers OK 74523 | |
| (580) 982-6044 | |
| Not Available |
| Full Name | Restore Family Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 416020 E 1951 Rd, Antlers, Oklahoma |
| Authorized Official Name and Position | Terry Jean Draper (OWNEER) |
| Authorized Official Contact | 5809826044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Family Medical Clinic 416020 E 1951 Rd Antlers OK 74523 Ph: (580) 982-6044 | Restore Family Medical Clinic 416020 E 1951 Rd Antlers OK 74523 Ph: (580) 982-6044 |
| NPI Number | 1528545472 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 07/24/2018 |
| Medicare PECOS PAC ID | 8921357765 |
|---|---|
| Medicare Enrollment ID | O20180828000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528545472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 55841 (Oklahoma) | Primary |
| Provider Name | Angelena Frost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639450448 PECOS PAC ID: 0547428088 Enrollment ID: I20141001000374 |
| Provider Name | Terry J Draper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942793351 PECOS PAC ID: 1355354481 Enrollment ID: I20180828000542 |
| Provider Name | Kendall Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346819802 PECOS PAC ID: 9234528977 Enrollment ID: I20211117003167 |
Rowland Flatt Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Ne 2nd St, Antlers, OK 74523 Phone: 580-298-3351 Fax: 580-298-3803 | |
Hrh Medical Group, Antlers Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 302 E Main St, Antlers, OK 74523 Phone: 580-749-4065 Fax: 580-749-4056 |