| Roger Mills County Hospital Authority | |
|
501 S Ll Males Cheyenne OK 73628 | |
| (580) 497-3336 | |
| (580) 497-2778 |
| Full Name | Roger Mills County Hospital Authority |
|---|---|
| Speciality | Family Medicine |
| Location | 501 S Ll Males, Cheyenne, Oklahoma |
| Authorized Official Name and Position | Cynthia Ellen Duncan (CEO) |
| Authorized Official Contact | 5804973336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roger Mills County Hospital Authority Po Box 219 Cheyenne OK 73628-0219 Ph: (580) 497-3336 | Roger Mills County Hospital Authority 501 S Ll Males Cheyenne OK 73628 Ph: (580) 497-3336 |
| NPI Number | 1760583942 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 01/15/2018 |
| Medicare PECOS PAC ID | 7113827403 |
|---|---|
| Medicare Enrollment ID | O20040112000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760583942 | NPI | - | NPPES |
| 100699820D | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John M Hubanks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477578995 PECOS PAC ID: 7113980236 Enrollment ID: I20041110000165 |
| Provider Name | Treva J Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881773703 PECOS PAC ID: 0244264083 Enrollment ID: I20100831000647 |
| Provider Name | Sonja D Langley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962821074 PECOS PAC ID: 8527321058 Enrollment ID: I20180417000017 |
| Provider Name | Mikal D Phillips-edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396234902 PECOS PAC ID: 3274888011 Enrollment ID: I20180619000759 |
Roger Mills County Hospital Authority Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 Fk Buster Ave, Cheyenne, OK 73628 Phone: 580-497-3333 Fax: 580-497-2778 |