Jonathan Harvey Soekamto, DO | |
2100 W Iowa Ave Ste A, Chickasha, OK 73018-2736 | |
(405) 224-2100 | |
Not Available |
Full Name | Jonathan Harvey Soekamto |
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Gender | Male |
Speciality | Family Medicine |
Location | 2100 W Iowa Ave Ste A, Chickasha, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811518806 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 8264 (Oklahoma) | Primary |
Entity Name | Grady Memorial Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164859260 PECOS PAC ID: 0648175778 Enrollment ID: O20150520000323 |
Mailing Address | Practice Location Address |
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Jonathan Harvey Soekamto, DO 2100 W Iowa Ave Ste A, Chickasha, OK 73018-2736 Ph: (405) 224-2100 | Jonathan Harvey Soekamto, DO 2100 W Iowa Ave Ste A, Chickasha, OK 73018-2736 Ph: (405) 224-2100 |
Mrs. Abby Marie Housman, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 W Iowa Ave, Suite A, Chickasha, OK 73018 Phone: 405-224-2100 Fax: 405-779-2855 | |
Katie Allyse Dudley, APRN, CNP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 W Iowa Ave Ste A, Chickasha, OK 73018 Phone: 405-224-2100 Fax: 405-779-2310 | |
Kevin Anderson, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 W Iowa Ave, Suite A, Chickasha, OK 73018 Phone: 405-224-2100 Fax: 405-779-2855 | |
Mary Masterman, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 W Iowa Ave Ste A, Chickasha, OK 73018 Phone: 405-224-2100 Fax: 405-779-2310 | |
Kacey L Wallace, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1000 W Choctaw Ave Ste 9, Chickasha, OK 73018 Phone: 405-544-2940 Fax: 405-337-9632 | |
Sibin Nair, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 W Iowa Ave Ste A, Chickasha, OK 73018 Phone: 405-224-2100 | |
Jeffrey Lee Miller, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 W Iowa Ave, Chickasha, OK 73018 Phone: 405-224-2100 Fax: 405-779-2310 |