| Southeastern Oklahoma Family Services, Inc | |
|
113653 Old Highway 69 Checotah OK 74426-8802 | |
| (580) 565-4235 | |
| Not Available |
| Full Name | Southeastern Oklahoma Family Services, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 113653 Old Highway 69, Checotah, Oklahoma |
| Authorized Official Name and Position | Bre'yon James (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9184901352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Oklahoma Family Services, Inc Po Box 1709 Kingston OK 73439-1709 Ph: (580) 564-7374 | Southeastern Oklahoma Family Services, Inc 113653 Old Highway 69 Checotah OK 74426-8802 Ph: (580) 565-4235 |
| NPI Number | 1255648580 |
|---|---|
| Provider Enumeration Date | 09/08/2010 |
| Last Update Date | 10/09/2025 |
| Medicare PECOS PAC ID | 4284772328 |
|---|---|
| Medicare Enrollment ID | O20120111000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255648580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Ivora P Sensibaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730474073 PECOS PAC ID: 3173846532 Enrollment ID: I20141216002452 |
| Provider Name | Tierra J Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487015475 PECOS PAC ID: 3577841956 Enrollment ID: I20161107000920 |
| Provider Name | Seth Aaron Stambaugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730706219 PECOS PAC ID: 6507273125 Enrollment ID: I20210916001855 |
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