Dr Dante Perez, MD | |
100 S Bliss Ave, Tahlequah, OK 74464-2512 | |
(918) 458-3120 | |
(918) 458-3279 |
Full Name | Dr Dante Perez |
---|---|
Gender | Male |
Speciality | Pediatrics |
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 |
---|---|---|---|
1689856254 | NPI | - | NPPES |
150301001 | Medicaid | AK | |
100220460A | Other | OK | SOONERCARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 19710 (Oklahoma) | Primary |
Entity Name | Cherokee Nation |
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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 |
---|---|
Dr Dante Perez, MD Po Box 1920, Tahlequah, OK 74465-1920 Ph: (918) 458-3120 | Dr Dante Perez, MD 100 S Bliss Ave, Tahlequah, OK 74464-2512 Ph: (918) 458-3120 |
Dr. Elaine Kennedy, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 100 S Bliss Ave, Pediatrics Clinic, Tahlequah, OK 74464 Phone: 918-458-3120 | |
Dr. Gary Lynn Gaston, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1310 E Boone St, Tahlequah, OK 74464 Phone: 918-456-7700 | |
Megan Melott Moss, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1310 E Boone St, Tahlequah, OK 74464 Phone: 918-456-7700 Fax: 918-458-9314 | |
Dr. Kimberly Ann Milford, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1500 E Downing St Ste 102, Tahlequah, OK 74464 Phone: 918-207-0773 Fax: 918-207-0774 | |
Angel Javier Morales, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464 Phone: 918-458-3100 Fax: 918-458-3279 | |
Edward Ernest Gustavson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1310 E Boone St, Tahlequah, OK 74464 Phone: 918-456-7700 Fax: 918-458-9314 | |
Mrs. Kailey Madison Haley, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 19600 E Ross St, Tahlequah, OK 74464 Phone: 539-234-1000 |