| Triad Complete Healthcare | |
|
3013 Azalea Park Dr Muskogee OK 74401-2285 | |
| (918) 691-8391 | |
| Not Available |
| Full Name | Triad Complete Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 3013 Azalea Park Dr, Muskogee, Oklahoma |
| Authorized Official Name and Position | Niki Sykora (OWNER) |
| Authorized Official Contact | 9186918391 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Triad Complete Healthcare 3013 Azalea Park Dr Muskogee OK 74401-2285 Ph: (918) 691-8391 | Triad Complete Healthcare 3013 Azalea Park Dr Muskogee OK 74401-2285 Ph: (918) 691-8391 |
| NPI Number | 1063118529 |
|---|---|
| Provider Enumeration Date | 02/06/2023 |
| Last Update Date | 02/07/2023 |
| Medicare PECOS PAC ID | 9335507607 |
|---|---|
| Medicare Enrollment ID | O20230619000075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063118529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shelly D Mansker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639436348 PECOS PAC ID: 4082864715 Enrollment ID: I20121015000631 |
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