Individual ProviderMichael R TalleyFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address124 N 6th St, Okeene, OK 73763(580) 822-4404PECOS EnrollmentBased on the most recent information from CMS, provider Michael R Talley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1740224955Provider TypeIndividualFull NameTalley, Michael RCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date6/16/2006Last Updated11/17/2020Contact InformationPractice LocationPractice Address124 N 6th St, Okeene, OK 73763Phone(580) 822-4404Fax(580) 822-4403Mailing LocationMailing Address124 N 6th St, Okeene, OK 73763Phone(580) 822-4404Fax(580) 822-4403Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense13660OklahomaProvider IdentifiersIDDescriptionIssuerIDP00285340DescriptionOtherIssuerRAILROAD MEDICAREID730793801003DescriptionOtherIssuerBCBSOklahomaID100123710ADescriptionMedicaidIssuerUnlistedOklahoma