Dr Glen Ray Hanson, MD | |
3315 Kethley Rd, Shawnee, OK 74804-9638 | |
(405) 273-5801 | |
(405) 878-3814 |
Full Name | Dr Glen Ray Hanson |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 35 Years |
Location | 3315 Kethley Rd, Shawnee, Oklahoma |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497795652 | NPI | - | NPPES |
100094710A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 18843 (Oklahoma) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Ssm Health St Anthony Hospital - Shawnee | Shawnee, OK | Hospital |
Ssm Health St Anthony Hospital - Oklahoma City | Oklahoma city, OK | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Shawnee Medical Center Clinic, Inc. | 3870405434 | 76 |
Saints Medical Group, Llc | 7012914898 | 358 |
Entity Name | Shawnee Medical Center Clinic, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881648285 PECOS PAC ID: 3870405434 Enrollment ID: O20031103000239 |
Entity Name | Ssm Health Care Of Oklahoma, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033283932 PECOS PAC ID: 6709771207 Enrollment ID: O20040216000184 |
Entity Name | Saints Medical Group, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437195922 PECOS PAC ID: 7012914898 Enrollment ID: O20061109000189 |
Mailing Address | Practice Location Address |
---|---|
Dr Glen Ray Hanson, MD Po Box 849, Shawnee, OK 74802-0849 Ph: (405) 273-5801 | Dr Glen Ray Hanson, MD 3315 Kethley Rd, Shawnee, OK 74804-9638 Ph: (405) 273-5801 |
Dr. Grant Lee Mcclune, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3315 Kethley Rd, Shawnee, OK 74804 Phone: 405-273-5801 Fax: 405-878-3814 | |
Dr. Matthew Marcus Mctague, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3315 Kethley Rd, Shawnee, OK 74804 Phone: 405-273-5801 Fax: 405-878-3794 | |
Dr. Michael Brent Wiens, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3315 Kethley Rd, Shawnee, OK 74804 Phone: 405-273-5801 Fax: 405-878-3794 | |
Dr. Jennifer Linn Wentzel, M.D., M.S. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3315 Kethley Rd, Shawnee, OK 74804 Phone: 405-273-5801 Fax: 053-955-9264 | |
Dr. Wit Chainakul, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1902 S Gordon Cooper Dr, Shawnee, OK 74801 Phone: 405-275-5555 |