ROLAND PRIMARY CARE CLINIC LLC (NPI# 1053730903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053730903 |
| Entity Type | Organization |
| Organization Name | ROLAND PRIMARY CARE CLINIC LLC |
| Practice Address |
309 E Ray Fine Blvd Roland OK 74954-5160 |
| Practice Telephone | 9185036276 |
| Practice Fax Number | 9418503627 |
| Mailing Telephone | 9185036276 |
| Mailing Fax Number | 9418503627 |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2014-04-08 |
| Authorized Official Name | DR. FREDERICK J FUOCO (PRESIDENT) |
| Authorized Official Telephone | 9185036276 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | OK | Allopathic & Osteopathic Physicians |
| Street Address |
309 E RAY FINE BLVD |
| City | ROLAND |
| State | OK |
| Zip Code | 74954-5160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164718961 | Ucr Medical, Inc | Clinic/Center | 309 E Ray Fine Blvd, Roland, OK 74954-5160 | 2011-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164969887 | Trinka Blankenship | Case Manager/Care Coordinator | 509 Dewey St, Poteau, OK 74954 | 2017-01-20 |
| 1972959625 | Karen Lynn Williams | Nurse Practitioner | 508 W. Ray Fine Blvd, Roland, OK 74954 | 2016-05-12 |
| 1285068791 | St. Madron Medical Clinic | Specialist | 205 E. Ray Fine Blvd St. 6, Roland, OK 74954 | 2013-09-03 |
| 1316178155 | Kimberley Ann Brunk | Optometrist | 1022 East Ray Fine Boulevard Suite 5, Roland, OK 74954 | 2009-07-28 |
| 1891939765 | Gary L Axley | Acupuncturist | 303 E. Ray Fine Blvd, Ste 3, Roland, OK 74954 | 2009-04-23 |
| 1598944944 | Seubold Family Chiropractic Inc | Chiropractor | 311 4 E Ray Fine Blvd, Suite4, Roland, OK 74954 | 2007-11-01 |
| 1689799793 | Cynthia Carol Almond | Preventive Medicine | 309 East Ray Fine Blvd, Roland, OK 74954 | 2007-03-20 |
| 1457498644 | Robert Kale | Anesthesiology | 100 East Ray Fine Blvd., Suite Q, Roland, OK 74954 | 2007-01-30 |
| 1255491494 | Lequita J. Joyce Inc | Counselor | 100 East Ray Fine Blvd, Roland, OK 74954 | 2006-12-11 |
| 1174604268 | Morgan A Seubold | Chiropractor | 1022 E Ray Fine Blvd, Ste 4, Roland, OK 74954 | 2006-10-17 |
| Find all providers in zip 74954 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821276304 | Tougas Chiropractic Clinic | General Practice | 205 E Ray Fine Blvd, Suite #6, Roland, OK 74954-5181 | 2008-02-06 |
| 1518014729 | John C Friedl | General Practice | 205 E Ray Fine Blvd, Suite 6, Roland, OK 74954-5380 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417565433 | Robinson Medical Clinic West, LLC | General Practice | 1900 W 2nd St Ste D, Elk City, OK 73644-4328 | 2020-07-15 |
| 1669080891 | Prairie Gardens Medical LLC | General Practice | 1213 Nw 122nd St Ste 401, Oklahoma City, OK 73114-7000 | 2020-07-14 |
| 1801431135 | Cristina Elisa Collazo-suarez | General Practice | 401 Nw 76th St, Lawton, OK 73505-5338 | 2019-11-11 |
| 1578117859 | Tulsa Wellness Management, LLC | General Practice | 3501 S Yale Ave Ste A, Tulsa, OK 74135-8014 | 2019-07-25 |
| 1053875781 | Oumi Clinics LLC | General Practice | 1200 Childrens Ave Ste 11200, Oklahoma City, OK 73104-4637 | 2019-01-28 |
| 1902396294 | Gail Renee Marchant | General Practice | 8784 E 105th Ct, Tulsa, OK 74133-7063 | 2018-05-13 |
| 1528578499 | Revive Medical LLC | General Practice | 4215 N Classen Blvd Ste 103, Oklahoma City, OK 73118 | 2017-10-05 |
| 1992214548 | Lifestyle Medical Center, Pllc | General Practice | 4505 S Harvard Ave, Tulsa, OK 74135-2905 | 2017-09-27 |
| 1265884449 | Turning Point Health LLC | General Practice | 736 W Main St, Jenks, OK 74037-3519 | 2016-07-12 |
| 1891149647 | Daniel Enriquez | General Practice | 1040 7050 S Air Depot Blvd, Oklahoma City, OK 73135 | 2016-04-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.