Dr Jacob Blaine Oldham, | |
4830 Highway 260 Ste 103, Lakeside, AZ 85929-5851 | |
(928) 537-8777 | |
(928) 537-1914 |
Full Name | Dr Jacob Blaine Oldham |
---|---|
Gender | Male |
Speciality | Orthopedic Surgery |
Experience | 24 Years |
Location | 4830 Highway 260 Ste 103, Lakeside, Arizona |
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 |
---|---|---|---|
1033109632 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | MD2005-0490 (New Mexico) | Secondary |
207X00000X | Orthopaedic Surgery | 41236 (Arizona) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Summit Healthcare Regional Medical Center | Show low, AZ | Hospital |
White Mountain Regional Medical Center | Springerville, AZ | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
White Mountain Communities Hospital, Inc. | 1951203512 | 14 |
Oldham Ortho Pllc | 3173995503 | 2 |
Summit Healthcare Medical Associates | 8729205737 | 79 |
Entity Name | Kingman Healthcare Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265423917 PECOS PAC ID: 6901791367 Enrollment ID: O20040216001173 |
Entity Name | Summit Healthcare Medical Associates |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467878108 PECOS PAC ID: 8729205737 Enrollment ID: O20140815000931 |
Entity Name | Oldham Ortho Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578280681 PECOS PAC ID: 3173995503 Enrollment ID: O20230214000855 |
Mailing Address | Practice Location Address |
---|---|
Dr Jacob Blaine Oldham, 4830 Highway 260 Ste 103, Lakeside, AZ 85929-5851 Ph: (928) 537-8777 | Dr Jacob Blaine Oldham, 4830 Highway 260 Ste 103, Lakeside, AZ 85929-5851 Ph: (928) 537-8777 |
Jeffrey Maurice Reagan, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4830 Highway 260 Ste 103, Lakeside, AZ 85929 Phone: 928-537-8777 Fax: 928-537-1914 | |
Laura L Vandenheede, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 5658 Highway 260, Suite 7, Lakeside, AZ 85929 Phone: 928-537-3399 Fax: 928-537-0475 |