| Robert V Blakeburn Md Pc | |
|
800 Frisco Ave Clinton OK 73601-3306 | |
| (580) 323-2700 | |
| (580) 323-2718 |
| Full Name | Robert V Blakeburn Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 800 Frisco Ave, Clinton, Oklahoma |
| Authorized Official Name and Position | Robert Van Blakeburn (PRESIDENT/OWNER) |
| Authorized Official Contact | 5803232700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert V Blakeburn Md Pc 800 Frisco Ave Clinton OK 73601-3306 Ph: (580) 323-2700 | Robert V Blakeburn Md Pc 800 Frisco Ave Clinton OK 73601-3306 Ph: (580) 323-2700 |
| NPI Number | 1033106448 |
|---|---|
| Provider Enumeration Date | 09/30/2005 |
| Last Update Date | 08/26/2009 |
| Medicare PECOS PAC ID | 0446293120 |
|---|---|
| Medicare Enrollment ID | O20050801000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033106448 | NPI | - | NPPES |
| 100110960C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 17199 (Oklahoma) | Primary |
| Provider Name | Robert V Blakeburn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164419560 PECOS PAC ID: 7416985429 Enrollment ID: I20050803000630 |
| Provider Name | Angela D Pope-bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629209721 PECOS PAC ID: 4880732940 Enrollment ID: I20091110000318 |
| Provider Name | Ashley D Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245586924 PECOS PAC ID: 3375784614 Enrollment ID: I20130729000619 |
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Alliancehealth Clinic Clinton Hills Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 S 30th St, Clinton, OK 73601 Phone: 580-323-2300 Fax: 580-323-8170 |