| Washita Medical Center Llc | |
|
38509 State Hwy 7 Davis OK 73030 | |
| (405) 207-7696 | |
| (800) 396-6706 |
| Full Name | Washita Medical Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 38509 State Hwy 7, Davis, Oklahoma |
| Authorized Official Name and Position | Stefanie Fisher (APN/PROVIDER) |
| Authorized Official Contact | 4052077696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Washita Medical Center Llc Po Box 157 Hennepin OK 73444-0157 Ph: (405) 207-7696 | Washita Medical Center Llc 38509 State Hwy 7 Davis OK 73030 Ph: (405) 207-7696 |
| NPI Number | 1356925473 |
|---|---|
| Provider Enumeration Date | 05/06/2021 |
| Last Update Date | 05/06/2021 |
| Medicare PECOS PAC ID | 3274932884 |
|---|---|
| Medicare Enrollment ID | O20210714000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356925473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Ashli Stamper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790370559 PECOS PAC ID: 1759780356 Enrollment ID: I20210602001748 |
| Provider Name | Stefanie Jane Mckee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629680038 PECOS PAC ID: 4082013594 Enrollment ID: I20210714000323 |
| Provider Name | Mariah Nichole Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235871336 PECOS PAC ID: 6901289115 Enrollment ID: I20220826000220 |
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