| Triad Complete Womens Healthcare, Llc | |
|
119 Patton Dr Ponca City OK 74601-2030 | |
| (580) 765-9451 | |
| Not Available |
| Full Name | Triad Complete Womens Healthcare, Llc |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 119 Patton Dr, Ponca City, Oklahoma |
| Authorized Official Name and Position | Matthew Bintz (CEO) |
| Authorized Official Contact | 9702707929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Triad Complete Womens Healthcare, Llc 2703 N 14th Street Ponca City OK 74601 Ph: (580) 765-9451 | Triad Complete Womens Healthcare, Llc 119 Patton Dr Ponca City OK 74601-2030 Ph: (580) 765-9451 |
| NPI Number | 1861128555 |
|---|---|
| Provider Enumeration Date | 07/26/2022 |
| Last Update Date | 09/18/2022 |
| Medicare PECOS PAC ID | 3173909009 |
|---|---|
| Medicare Enrollment ID | O20220930000132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861128555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Primary |
| Provider Name | Sean W Reid |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538517842 PECOS PAC ID: 1759669633 Enrollment ID: I20201119001188 |
| Provider Name | Abby Marie Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467104992 PECOS PAC ID: 3173905338 Enrollment ID: I20220804000473 |
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