| Southeast Oklahoma Medical Clinic, Llc | |
|
1308 E Carl Albert Pkwy Mcalester OK 74501-5236 | |
| (580) 927-2334 | |
| Not Available |
| Full Name | Southeast Oklahoma Medical Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1308 E Carl Albert Pkwy, Mcalester, Oklahoma |
| Authorized Official Name and Position | Richard J Helton (OWNER) |
| Authorized Official Contact | 5809272334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Oklahoma Medical Clinic, Llc 108 W Ohio Ave Coalgate OK 74538-2827 Ph: (580) 927-2334 | Southeast Oklahoma Medical Clinic, Llc 1308 E Carl Albert Pkwy Mcalester OK 74501-5236 Ph: (580) 927-2334 |
| NPI Number | 1467993253 |
|---|---|
| Provider Enumeration Date | 03/14/2017 |
| Last Update Date | 03/14/2017 |
| Medicare PECOS PAC ID | 8527324680 |
|---|---|
| Medicare Enrollment ID | O20171107001072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467993253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Richard J Helton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972545820 PECOS PAC ID: 2769370113 Enrollment ID: I20040723000951 |
| Provider Name | Kandra L Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003393778 PECOS PAC ID: 0840540498 Enrollment ID: I20190308001776 |
| Provider Name | Jodie H Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669031266 PECOS PAC ID: 3779810882 Enrollment ID: I20190813001246 |
| Provider Name | Chrissy M Lehew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184274052 PECOS PAC ID: 9032530241 Enrollment ID: I20200526001656 |
| Provider Name | Ronda M Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770244675 PECOS PAC ID: 0042604928 Enrollment ID: I20220221000147 |
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