John W C Wyden Ii, | |
112 N High St, Antlers, OK 74523-2250 | |
(580) 298-3001 | |
(580) 298-5357 |
Full Name | John W C Wyden Ii |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 112 N High St, Antlers, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588903959 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Entity Name | Our House Mhsa Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790144160 PECOS PAC ID: 8628428455 Enrollment ID: O20240513003509 |
Mailing Address | Practice Location Address |
---|---|
John W C Wyden Ii, 112 N High St, Antlers, OK 74523-2250 Ph: (580) 298-3001 | John W C Wyden Ii, 112 N High St, Antlers, OK 74523-2250 Ph: (580) 298-3001 |
Kimberly R Couch, Counselor Medicare: Not Enrolled in Medicare Practice Location: 903 W Main St, Antlers, OK 74523 Phone: 580-298-3001 | |
Sierra Hurley Allen, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1322 W Main St, Antlers, OK 74523 Phone: 580-298-5062 | |
Mrs. Stacey Colette Franks, MBS,LBP Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 N High St, Antlers, OK 74523 Phone: 580-298-5779 Fax: 580-298-6699 | |
Ms. Sandy Keesee, Counselor Medicare: Not Enrolled in Medicare Practice Location: 112 N High St, Antlers, OK 74523 Phone: 580-298-3001 Fax: 580-298-5357 | |
Elizabeth Lanell Warren, Counselor Medicare: Medicare Enrolled Practice Location: 1322 W Main St, Antlers, OK 74523 Phone: 580-298-5062 Fax: 580-298-9958 | |
Ms. Kathy L Pendergraft, Counselor Medicare: Medicare Enrolled Practice Location: 112 N High St, Antlers, OK 74523 Phone: 580-298-3001 Fax: 580-298-5357 | |
Jordan Hayes, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1322 W Main St, Antlers, OK 74523 Phone: 580-298-5062 Fax: 580-298-9958 |