FAIRFAX MEDICAL FACILITIES INC NPI 1538183173

NPI Information

NPI: 1538183173
Provider Name: FAIRFAX MEDICAL FACILITIES INC

Doing Business As: ROBERT CLARK FAMILY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
212 N MAIN ST
FAIRFAX, OK
ZIP 74637
Phone: (918) 642-3100
Get Directions

FAIRFAX MEDICAL FACILITIES INC is a federally qualified health center (fqhc) clinic center in Fairfax, OK. FAIRFAX MEDICAL FACILITIES INC NPI is 1538183173. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Robert Clark Family Health Center.

The provider's business location address is:

212 N MAIN ST
FAIRFAX, OK
ZIP 74637-023
Phone: (918) 642-3100
Fax: (918) 642-5639

The provider's authorized official is Karen Mcconnell .
The authorized official title is Ceo and has the following contact phone number (918) 642-3100.

The CLIA number assigned to this NPI record is 37D0475572 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/27/2006 and was last updated on 1/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207Q00000X	Family Medicine		No
2	208D00000X	General Practice		No
3	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes
4	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	200071420D	MEDICAID	OKLAHOMA
2	371843	MEDICARE OSCAR/CERTIFICATION	OKLAHOMA
3	300522212	MEDICARE PIN	OKLAHOMA
4	DE6189	MEDICARE PIN	OKLAHOMA
5	200071420B	MEDICAID	OKLAHOMA
6	371842	MEDICARE OSCAR/CERTIFICATION	OKLAHOMA
7	200071420G	MEDICAID	OKLAHOMA
8	200071420E	MEDICAID	OKLAHOMA
9	200071420F	MEDICAID	OKLAHOMA
10	371838	MEDICARE OSCAR/CERTIFICATION	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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