| Tahlequah Medical Group Primary Care | |
|
1201 E Ross Byp Tahlequah OK 74464-4188 | |
| (918) 207-0991 | |
| (918) 456-7570 |
| Full Name | Tahlequah Medical Group Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1201 E Ross Byp, Tahlequah, Oklahoma |
| Authorized Official Name and Position | Julie Ward (CFO) |
| Authorized Official Contact | 9184532120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tahlequah Medical Group Primary Care Po Box 500 Tahlequah OK 74465-0500 Ph: (918) 207-0991 | Tahlequah Medical Group Primary Care 1201 E Ross Byp Tahlequah OK 74464-4188 Ph: (918) 207-0991 |
| NPI Number | 1306387949 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 05/18/2017 |
| Medicare PECOS PAC ID | 1456255025 |
|---|---|
| Medicare Enrollment ID | O20170605000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306387949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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