| Walkup Family Medicine Clinic Llc | |
|
1302 S Lynn Ln Idabel OK 74745-6860 | |
| (405) 639-7771 | |
| Not Available |
| Full Name | Walkup Family Medicine Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1302 S Lynn Ln, Idabel, Oklahoma |
| Authorized Official Name and Position | Stormy Walkup (OWNER) |
| Authorized Official Contact | 4056397771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walkup Family Medicine Clinic Llc 1302 S Lynn Ln Idabel OK 74745-6860 Ph: (580) 286-3993 | Walkup Family Medicine Clinic Llc 1302 S Lynn Ln Idabel OK 74745-6860 Ph: (405) 639-7771 |
| NPI Number | 1508461856 |
|---|---|
| Provider Enumeration Date | 12/03/2020 |
| Last Update Date | 01/10/2022 |
| Medicare PECOS PAC ID | 6507279171 |
|---|---|
| Medicare Enrollment ID | O20201229001497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508461856 | NPI | - | NPPES |
| 200730970A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Stormy Walkup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710428958 PECOS PAC ID: 6406128594 Enrollment ID: I20171006000952 |
| Provider Name | Jennifer Lee Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245803345 PECOS PAC ID: 9830596519 Enrollment ID: I20210922002581 |
Mccurtain Memorial Medical Management, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1425 E Lincoln Rd, Idabel, OK 74745 Phone: 580-286-4900 Fax: 580-286-3955 | |
Thomas W. Salyer, Do, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1302 S Lynn Ln, Idabel, OK 74745 Phone: 580-286-3993 | |
George Edward Freeman, D.o.,p.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1425 E Lincoln Rd, Suite B-1, Idabel, OK 74745 Phone: 580-286-4949 Fax: 580-286-4946 | |
Kiamichi Family Medical Center Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2809 Ne Lincoln Rd, Idabel, OK 74745 Phone: 580-286-6688 Fax: 580-286-6699 | |
Kiamichi Family Medical Center Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2809 Ne Lincoln Rd, Idabel, OK 74745 Phone: 580-286-6688 Fax: 580-286-6699 | |
Ardeshir F. Nia, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1211 E Lincoln Rd, Idabel, OK 74745 Phone: 580-286-4300 Fax: 580-286-5530 | |
Choctaw Nation Of Oklahoma Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 902 E Lincoln Rd, Idabel, OK 74745 Phone: 918-567-7000 Fax: 918-567-7041 |