Jesse Craighead, | |
747 Highway 59 # 4, Westville, OK 74965-1508 | |
(918) 723-3757 | |
Not Available |
Full Name | Jesse Craighead |
---|---|
Gender | Male |
Speciality | Counselor |
Location | 747 Highway 59 # 4, Westville, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558722652 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 200534020A (Oklahoma) | Primary |
Entity Name | Cherokee Nation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780692723 PECOS PAC ID: 5799698742 Enrollment ID: O20031106000628 |
Mailing Address | Practice Location Address |
---|---|
Jesse Craighead, 747 Highway 59 # 4, Westville, OK 74965-1508 Ph: () - | Jesse Craighead, 747 Highway 59 # 4, Westville, OK 74965-1508 Ph: (918) 723-3757 |
Amy Rusk, Counselor Medicare: Not Enrolled in Medicare Practice Location: 747 Hwy 59 #4, Westville, OK 74965 Phone: 918-723-3735 Fax: 918-723-3730 | |
Jennie Pruitt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 747 Highway 59 Ste 4, Westville, OK 74965 Phone: 479-220-9857 | |
Charles Cornelius Pastoor, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 747 Highway 59, Westville, OK 74965 Phone: 918-723-3735 |