Dr Brent Wade Davis, DO is a medicare enrolled "Family Medicine" physician in Weleetka, Oklahoma. His current practice location is
315 W. 9 Street, Weleetka, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(405) 786-2248.
Dr Brent Wade Davis is licensed to practice in Oklahoma (license number 1913) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619009859.
Physician's Profile
| Full Name | Dr Brent Wade Davis |
|---|
| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 315 W. 9 Street, Weleetka, Oklahoma |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1619009859
- Provider Enumeration Date: 03/12/2007
- Last Update Date: 07/08/2011
Medicare PECOS Information:
- PECOS PAC ID: 9830101237
- Enrollment ID: I20140127001451
Medical Identifiers
Medical identifiers for Dr Brent Wade Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619009859 | NPI | - | NPPES |
| 100743630A | Medicaid | OK | |
| 100743630B | Medicaid | OK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 1913 (Oklahoma) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Brent Wade Davis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Brent Wade Davis, DO
Po Box 207,
Henryetta, OK 74437-0207
Ph: (405) 786-2248 | Dr Brent Wade Davis, DO
315 W. 9 Street,
Weleetka, OK 74880-0337
Ph: (405) 786-2248 |
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