Patrick Russell Gannon, MD | |
1 E Clark Bass Blvd, Suite 210, Mcalester, OK 74501-4209 | |
(918) 421-6987 | |
(918) 421-6698 |
Full Name | Patrick Russell Gannon |
---|---|
Gender | Male |
Speciality | Orthopedic Surgery |
Experience | 31 Years |
Location | 1 E Clark Bass Blvd, Mcalester, 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 |
---|---|---|---|
1790747426 | NPI | - | NPPES |
74502A024 | Other | OK | CHAMPUS |
G67583 | Other | OK | STERLING OPTION 1 |
1000176970A | Medicaid | OK | |
731310891006 | Other | OK | UNICARE |
1324230001 | Other | OK | PALMETTO DME |
731310891028 | Other | OK | TRICARE SOUTH |
0166707 | Other | OK | UMWA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | 20652 (Oklahoma) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Mcalester Regional Health Center | Mcalester, OK | Home health agency |
Angels Care Home Health Of East Oklahoma | Broken arrow, OK | Home health agency |
Mcalester Regional Health Center | Mcalester, OK | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mcalester Regional Health Center Authority | 6709796436 | 66 |
Mcalester Medical Services Llc | 9931139029 | 24 |
Entity Name | Mcalester Regional Health Center Authority |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316940034 PECOS PAC ID: 6709796436 Enrollment ID: O20040303001042 |
Entity Name | Mcalester Medical Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154317998 PECOS PAC ID: 9931139029 Enrollment ID: O20050818000234 |
Mailing Address | Practice Location Address |
---|---|
Patrick Russell Gannon, MD 1245 S Utica Ave, Fl 2, Tulsa, OK 74104-4214 Ph: (918) 579-2300 | Patrick Russell Gannon, MD 1 E Clark Bass Blvd, Suite 210, Mcalester, OK 74501-4209 Ph: (918) 421-6987 |
Gregg T Podleski, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1 E. Clark Bass Blvd, Ste 210, Mcalester, OK 74501 Phone: 918-421-3951 Fax: 918-421-6679 |