WALTERS FAMILY CLINIC (NPI# 1346428521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346428521 |
| Entity Type | Organization |
| Organization Name | WALTERS FAMILY CLINIC |
| Other Organization Name | LARRY GOSS M.D. |
| Practice Address |
102 N Broadway St Walters OK 73572-1258 |
| Practice Telephone | 5808753320 |
| Practice Fax Number | 5808753131 |
| Mailing Telephone | 5808753320 |
| Mailing Fax Number | 5808753131 |
| Enumeration Date | 2008-02-10 |
| Last Update Date | 2008-06-06 |
| Authorized Official Name | MRS. GLORIA E VAUGHN (OFFICE MANAGER) |
| Authorized Official Telephone | 5808753320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 10340 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200134580A | 05 | |
| OK | CLIA | 37D1084232 | 01 |
| Other Name | Type Code |
|---|---|
| Larry Goss M.D. | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | WALTERS FAMILY CLINIC, A PROFESSIONAL CORPORATION | 102 N Broadway St, Walters, OK 73572 |
| Street Address |
102 N BROADWAY ST |
| City | WALTERS |
| State | OK |
| Zip Code | 73572-1258 |
| 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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922044890 | Larry Gene Goss | General Practice | 230 1/2 E Missouri St, Walters, OK 73572-1434 | 2006-06-21 |
| 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 | ||||
Please comment or provide details below to improve the information on WALTERS FAMILY CLINIC.
| 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.