David James Wilson, DO | |
100 S Bliss Ave, Tahlequah, OK 74464-2512 | |
(918) 458-3100 | |
(918) 458-3511 |
Full Name | David James Wilson |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 100 S Bliss Ave, Tahlequah, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427168566 | NPI | - | NPPES |
100174400A | Medicaid | OK | |
150600003 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 01325 (Iowa) | Primary |
208600000X | Surgery | 2003 (Arizona) | Secondary |
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 |
---|---|
David James Wilson, DO 27 Gary Ct, Lake Ozark, MO 65049-6716 Ph: (573) 365-7241 | David James Wilson, DO 100 S Bliss Ave, Tahlequah, OK 74464-2512 Ph: (918) 458-3100 |
Joel Acopio Malabrigo, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464 Phone: 918-458-3100 Fax: 918-458-3511 | |
Henry Jake Whitener, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 19600 E Ross St, Tahlequah, OK 74464 Phone: 539-234-1000 | |
Dr. David Brent Rotton, DO, FACOS Surgery Medicare: Accepting Medicare Assignments Practice Location: 1500 E. Downing, #103, Tahlequah, OK 74464 Phone: 918-207-1140 Fax: 918-207-0335 | |
Daniel Lawrence Pablo, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464 Phone: 918-458-3360 Fax: 918-458-3511 | |
Mohamed Yousef Elsagga, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464 Phone: 918-458-3100 Fax: 918-458-3610 | |
James W Smith, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1400 E Downing St, Tahlequah, OK 74464 Phone: 918-456-0641 |