MEDICARE: NEIGHBORHOOD FAMILY CLINIC & MINOR

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	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730304320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD FAMILY CLINIC & MINOR

Provider Business Mailing Address
First Line	:	PO BOX 660
Second Line	:
City	:	PIEDMONT
State	:	OK
Zip	:	73078-0660
Country	:	US
Telephone Number	:	405-373-2400
Fax Number	:	405-373-4400

Provider Business Practice Location Address
First Line	:	6102 NW 63RD ST STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-7526
Country	:	US
Telephone Number	:	405-373-2400
Fax Number	:	405-373-4400

Authorized Official
Title or Position	:	OWNER
Name	:	ANTONIA PRATT-REID
Credential	:	ARNP
Telephone Number	:	405-373-2400

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	02/25/2016

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Directions to “NEIGHBORHOOD FAMILY CLINIC & MINOR ” Practice Location

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