| Weatherford Family Practice Medical Center Pllc | |
|
3739 Legacy Weatherford OK 73096-9746 | |
| (580) 772-2400 | |
| (580) 772-2408 |
| Full Name | Weatherford Family Practice Medical Center Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3739 Legacy, Weatherford, Oklahoma |
| Authorized Official Name and Position | Tamala Rochelle Mallett Moore (OWNER/MEDICAL DOCTOR) |
| Authorized Official Contact | 5807722400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Weatherford Family Practice Medical Center Pllc 3739 Legacy Weatherford OK 73096-9746 Ph: (580) 772-2400 | Weatherford Family Practice Medical Center Pllc 3739 Legacy Weatherford OK 73096-9746 Ph: (580) 772-2400 |
| NPI Number | 1528204567 |
|---|---|
| Provider Enumeration Date | 12/22/2008 |
| Last Update Date | 01/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528204567 | NPI | - | NPPES |
| P00691960 | Other | OK | RAIL ROAD MEDICARE PTAN |
| 200224110A | Medicaid | OK | |
| 26755 | Other | OK | OKLAHOMA STATE MEDICAL LICENSE |
| 37994 | Other | OK | BNDD |
| OKB5382 | Other | OK | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 26755 (Oklahoma) | Primary |
Team Clinics Ah Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 N Lark St, Weatherford, OK 73096 Phone: 405-546-4130 | |
Aaron Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 N Washington St Ste 4, Weatherford, OK 73096 Phone: 580-772-3030 | |
Oklahoma West Physicians Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 N Illinois St, Weatherford, OK 73096 Phone: 580-772-0223 Fax: 580-774-0650 | |
Xpress Wellness Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1303 N Washington St, Weatherford, OK 73096 Phone: 580-772-2845 | |
Weatherford Eyecare Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1545 N Washington St, Weatherford, OK 73096 Phone: 580-772-2819 Fax: 580-772-2805 | |
Blake A Badgett Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3731 Legacy, Weatherford, OK 73096 Phone: 580-772-6777 Fax: 580-772-2510 | |
Jonathan Ray Long Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 E Franklin Ave, Weatherford, OK 73096 Phone: 580-772-5600 Fax: 580-772-5604 |