Douglas Menz, D.O. P.C. – Primary Care Clinic/Center

Key facts

NPI: 1992996789
Entity type: Organization (NPI type 2)
Primary specialty: Primary Care Clinic/Center 261QP2300X
License: 3408 (OK)
Legal business name: DOUGLAS MENZ, D.O. P.C.
Practice address: 20912 SE 29TH St
Harrah, OK 73045-6439
Phone: (405) 391-2970
Fax: (405) 391-2972
NPI assigned: Aug 6, 2007
Organization subpart: No

Authorized official

Name: Dr. George Douglas Menz, D.O. NPI 1518977628
Title: Physician/Owner
Phone: (405) 391-2970

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

George Douglas Menz, D.O. Family Medicine Physician · Harrah, OK · NPI 1518977628

Medicare reassignment NPD Authorized official FAMILY MEDICINE · OK

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
37D0997934	Lake Pointe Medical Center 20912 SE 29TH Street, Harrah, OK 73045	Certificate of waiver	Aug 2, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OK

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20100514000284	OK	Part B Supplier - Clinic/Group Practice	5092843821	Receives reassigned benefits from 1 practitioner Practice locations: Harrah, OK

National Provider Directory

Locations

20912 SE 29th St
Harrah, OK 73045
Phone (405) 391-2970

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Primary Care Clinic/Center	261QP2300X	3408	OK	Yes

Addresses

Primary practice location

20912 SE 29TH St
Harrah, OK 73045-6439

Mailing address

20912 SE 29TH St
Harrah, OK 73045-6439
Phone (405) 391-2970

Other identifiers

Identifier	Type	State	Issuer
800522008	Other	OK	MEDICARE GROUP NUMBER

Other names

Lake Pointe Medical Center Doing business as

Other providers in Harrah, OK

All providers in Harrah, OK · Primary Care Clinic/Center in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.