| Dr Elaine Kennedy, MD | |
|
100 S Bliss Ave, Pediatrics Clinic, Tahlequah, OK 74464-2512 | |
| (918) 458-3120 | |
| Not Available |
| Full Name | Dr Elaine Kennedy |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Adolescent Medicine |
| 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 |
|---|---|---|---|
| 1083634935 | NPI | - | NPPES |
| 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 |
|---|---|
| Dr Elaine Kennedy, MD 1390 Heritage Ln, Pleasant View Apts # 92, Tahlequah, OK 74464-2136 Ph: () - | Dr Elaine Kennedy, MD 100 S Bliss Ave, Pediatrics Clinic, Tahlequah, OK 74464-2512 Ph: (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 |