| Mr Shiloh Wayne Martin, MED LPC | |
|
14674 S Highway 169, Oologah, OK 74053-3332 | |
| (580) 515-1167 | |
| Not Available |
| Full Name | Mr Shiloh Wayne Martin |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 14674 S Highway 169, Oologah, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255588901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 135786 (Alaska) | Secondary |
| 101YP2500X | Counselor - Professional | 4309 (Oklahoma) | Primary |
| Entity Name | Claremore Indian Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073527842 PECOS PAC ID: 9436069911 Enrollment ID: O20031210001104 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Shiloh Wayne Martin, MED LPC 14674 S Highway 169, Oologah, OK 74053-3332 Ph: (088) 452-2515 | Mr Shiloh Wayne Martin, MED LPC 14674 S Highway 169, Oologah, OK 74053-3332 Ph: (580) 515-1167 |
William R Hiddle, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12834 Old Us 169, Oologah, OK 74053 Phone: 918-695-2059 Fax: 918-221-7975 | |
Sarah Nicole Hawthorne, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12834 S Old Highway 169, Oologah, OK 74053 Phone: 918-695-2059 | |
Christopher Passmore, LPC Counselor Medicare: Medicare Enrolled Practice Location: 12834 Old Us 169, Oologah, OK 74053 Phone: 918-695-2059 Fax: 918-221-7975 | |
Wendy L Smith, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 12834 Old Hwy Us 169, Oologah, OK 74053 Phone: 918-695-2059 | |
Kelli Marie Ellis, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 15210 S 4060 Rd Lot B, Oologah, OK 74053 Phone: 918-230-9580 | |
Jennifer L. Bristow Cain, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12834 S Old Highway 169, Oologah, OK 74053 Phone: 918-695-2059 |