| Sallisaw Medical Clinic Llc | |
|
202 E Cherokee Ave Sallisaw OK 74955-4600 | |
| (918) 790-2890 | |
| (918) 790-2906 |
| Full Name | Sallisaw Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 202 E Cherokee Ave, Sallisaw, Oklahoma |
| Authorized Official Name and Position | Amelia L Poitevint (OWNER) |
| Authorized Official Contact | 9187902890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sallisaw Medical Clinic Llc 202 E Cherokee Ave Sallisaw OK 74955-4600 Ph: (918) 790-2890 | Sallisaw Medical Clinic Llc 202 E Cherokee Ave Sallisaw OK 74955-4600 Ph: (918) 790-2890 |
| NPI Number | 1306118377 |
|---|---|
| Provider Enumeration Date | 02/06/2012 |
| Last Update Date | 02/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306118377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4840 (Oklahoma) | Secondary |
| 207Q00000X | Family Medicine | 4825 (Oklahoma) | Primary |
| 363LF0000X | Nurse Practitioner - Family | R0074165 (Oklahoma) | Secondary |
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