Kelly Bacon, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Idabel, Oklahoma. His current practice location is
1301 E Lincoln Rd, Idabel, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(580) 286-7623.
Kelly Bacon is licensed to practice in Oklahoma (license number R0071221) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1700844313.
Provider's Profile
Full Name | Kelly Bacon |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 1301 E Lincoln Rd, Idabel, Oklahoma |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kelly Bacon attended and graduated from in
NPI Data:
- NPI Number: 1700844313
- Provider Enumeration Date: 05/03/2006
- Last Update Date: 10/26/2021
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Kelly Bacon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1700844313 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
367H00000X | Anesthesiologist Assistant | R0071221 (Oklahoma) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | R0071221 (Oklahoma) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Bacon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelly Bacon, Po Box 1547, Sedalia, MO 65302-1547 Ph: (660) 826-5960 | Kelly Bacon, 1301 E Lincoln Rd, Idabel, OK 74745-7300 Ph: (580) 286-7623 |
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