MEDICARE: FIRST MED CLINIC 39TH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1477992055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST MED CLINIC 39TH LLC

Provider Business Mailing Address
First Line	:	1221 N KELLY AVE
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-4865
Country	:	US
Telephone Number	:	405-471-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4510 NW 39TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73122-2503
Country	:	US
Telephone Number	:	405-495-5841
Fax Number	:	405-495-7825

Authorized Official
Title or Position	:	CEO
Name	:	TODD LECHTENBERGER
Credential	:
Telephone Number	:	405-471-6400

Provider Enumeration Date	:	06/18/2013
Last Update Date	:	06/18/2013

Similar Medicare Providers

1114027927 — BRUCE D THOMPSON MD
Practice Location Address:

4510 NW 39TH ST
OKLAHOMA CITY, OK
73122-2503

Practice Phone: 405-495-5841
Practice Fax:

1063672608 — SAMUEL BRANDON HANCOCK MD
Practice Location Address:

4510 NW 39TH ST
OKLAHOMA CITY, OK
73122-2503

Practice Phone: 405-495-5841
Practice Fax:

1639585045 — PRISCILA MOORES APRN
Practice Location Address:

4510 NW 39TH ST
OKLAHOMA CITY, OK
73122-2503

Practice Phone: 405-495-5841
Practice Fax: 405-495-7825

1124779129 — KELLIE DANIELLE SMITH FNP
Practice Location Address:

4510 NW 39TH ST
OKLAHOMA CITY, OK
73122-2503

Practice Phone: 405-759-4300
Practice Fax:

1700840055 — MARK EMORY WHITLEY M.D.
Practice Location Address:

3600 NW 138TH ST , SUITE 102
OKLAHOMA CITY, OK
73134-2503

Practice Phone: 405-286-4114
Practice Fax: 405-463-0154

1891743373 — THOMAS SIGURD GRIGGS MD
Practice Location Address:

3600 NW 138TH ST , SUITE 102
OKLAHOMA CITY, OK
73134-2503

Practice Phone: 405-286-4114
Practice Fax: 405-463-0154

Directions to “FIRST MED CLINIC 39TH LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.