Dr Leroy Southmayd Iii, MD | |
1202 W Wilshire Blvd, Oklahoma City, OK 73116-6109 | |
(405) 823-3073 | |
Not Available |
Full Name | Dr Leroy Southmayd Iii |
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Gender | Male |
Speciality | Internal Medicine - Nephrology |
Location | 1202 W Wilshire Blvd, Oklahoma City, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851351969 | NPI | - | NPPES |
100219420B | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RN0300X | Internal Medicine - Nephrology | 17164 (Oklahoma) | Primary |
Entity Name | Integris Ambulatory Care Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750333936 PECOS PAC ID: 2365408465 Enrollment ID: O20041209000354 |
Entity Name | Healogics Specialty Physicians Of Oklahoma Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144625740 PECOS PAC ID: 2264758705 Enrollment ID: O20150227001987 |
Mailing Address | Practice Location Address |
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Dr Leroy Southmayd Iii, MD 1202 W Wilshire Blvd, Oklahoma City, OK 73116-6109 Ph: (405) 823-3073 | Dr Leroy Southmayd Iii, MD 1202 W Wilshire Blvd, Oklahoma City, OK 73116-6109 Ph: (405) 823-3073 |
Evelyn Lorents, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 920 Sl Young Blvd, Oklahoma City, OK 73104 Phone: 405-271-5963 | |
Patrick Bronson Reeves, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 3366 Nw Expressway Ste 550, Oklahoma City, OK 73112 Phone: 405-942-5442 Fax: 405-942-6448 | |
Dr. Jake Lee Evans, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 800 Stanton L Young Blvd, Aat 6300, Oklahoma City, OK 73104 Phone: 405-271-5963 | |
Dr. Shawn Patel, MD Nephrology Medicare: Medicare Enrolled Practice Location: 1200 Childrens Ave Ste 14000, Oklahoma City, OK 73104 Phone: 405-271-5211 | |
Metri Haddaden, MD Nephrology Medicare: Medicare Enrolled Practice Location: 800 Stanton L Young Blvd # 8425, Oklahoma City, OK 73104 Phone: 405-271-6173 Fax: 410-554-2184 | |
Divya Sharma Divyadarshini, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 800 Stanton L Young Blvd, Oklahoma City, OK 73104 Phone: 405-271-5963 | |
Dr. Philip Barton Miner, Jr., M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 1000 N Lincoln Blvd, Suite 210, Oklahoma City, OK 73104 Phone: 405-271-4644 Fax: 405-271-3296 |