COTTON COUNTY FAMILY MEDICAL CENTER (NPI# 1558684092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558684092 |
| Entity Type | Organization |
| Organization Name | COTTON COUNTY FAMILY MEDICAL CENTER |
| Practice Address |
629 E Missouri Walters OK 73572-1605 |
| Mailing Address |
629 E Missouri St Walters OK 73572-1605 |
| Practice Telephone | 5808752800 |
| Practice Fax Number | 5808752881 |
| Mailing Telephone | 5808752800 |
| Mailing Fax Number | 5808752881 |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-09-10 |
| Authorized Official Name | DR. JEFFERY CHARLES HICKMAN (PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 5808752800 |
| Authorized Official Credential | D.C., P.A.-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | COTTON COUNTY FAMILY MEDICAL CENTER, LLC | 629 E. Missouri, Walters, OK 73572 |
| Street Address |
629 E MISSOURI |
| City | WALTERS |
| State | OK |
| Zip Code | 73572-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578529111 | Personal Touch of Walters, Oklahoma, Inc. | Home Health | 230 E Missouri, Walters, OK 73572 | 2006-04-22 |
| 1467438788 | Floyd J Lashley Jr. | Family Medicine | 402 N Broadway, Walters, OK 73572 | 2005-12-19 |
| 1962991919 | Local Med LLC | Family Medicine | 402 N Broadway St, Walters, OK 73572 | 2018-05-04 |
| 1821396946 | Brian Clayton Moore | Nurse Practitioner | 402 N Broadway St, Walters, OK 73572 | 2011-03-14 |
| 1003982620 | Piatt and Miller Inc | Skilled Nursing Facility | 600 East California, Walters, OK 73572-0246 | 2006-11-27 |
| 1265817498 | Jennifer King | Occupational Therapy Assistant | 1210 W Colorado St, Walters, OK 73572-1018 | 2015-07-29 |
| 1144704115 | Duncan Regional Hospital, Inc. | Clinic/Center | 402 N Broadway St, Walters, OK 73572-1230 | 2018-09-17 |
| 1477632263 | Willard Bill Freeman | Chiropractor | 202 W Missouri St, Walters, OK 73572-1246 | 2006-11-03 |
| 1588898753 | Jeff Hickman LLC | Chiropractor | 202 W Missouri St, Walters, OK 73572-1246 | 2009-05-04 |
| 1710162896 | Indian Territory Home Health Inc | Durable Medical Equipment & Medical Supplies | 105 N Broadway St, Walters, OK 73572-1257 | 2008-01-08 |
| Find all providers in zip 73572 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790392868 | James Scott Turner | Physician Assistant | 924 Nw 14th St, Moore, OK 73160-1610 | 2020-09-23 |
| 1386283679 | Cody Rice Chambers | Physician Assistant | 2002 12th Ave Nw Ste B, Ardmore, OK 73401-1206 | 2020-01-03 |
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1568920924 | Direct2u Urgent Care Pllc | Physician Assistant | 2417 County Road 1263, Blanchard, OK 73010-3123 | 2019-03-05 |
| 1538625660 | Symachia LLC | Physician Assistant | 115 N. Main St., Cashion, OK 73106 | 2019-02-13 |
| 1982172029 | William Landon Ross | Physician Assistant | 3705 W Memorial Rd Ste 101, Oklahoma City, OK 73134-1508 | 2018-11-07 |
| 1639646656 | Jacob Allbritton | Physician Assistant | 10824 Admiral Dr, Oklahoma City, OK 73162-6843 | 2018-10-29 |
| 1316420086 | Lauren Anto | Physician Assistant | 2824 Classen Blvd Ste 100, Norman, OK 73071-4059 | 2018-09-10 |
| 1073004768 | Shelby Teel | Physician Assistant | 1200 Everett Dr # 8305, Oklahoma City, OK 73104-5047 | 2018-05-29 |
| 1093240749 | Green's Country Clinic, LLC | Physician Assistant | 223 E Blackwell Ave, Blackwell, OK 74631-2909 | 2017-05-01 |
| 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.