| Adult Gastroenterology Associates Inc | |
|
6465 S Yale Ave Suite 1002 Tulsa OK 74136-7823 | |
| (918) 481-4700 | |
| (918) 481-4765 |
| Full Name | Adult Gastroenterology Associates Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6465 S Yale Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Douglas B Kliewer (PHYSICIAN) |
| Authorized Official Contact | 9184814700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult Gastroenterology Associates Inc 6465 S Yale Ave Suite1002 Tulsa OK 74136-7823 Ph: (918) 481-4700 | Adult Gastroenterology Associates Inc 6465 S Yale Ave Suite 1002 Tulsa OK 74136-7823 Ph: (918) 481-4700 |
| NPI Number | 1306884812 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 03/29/2016 |
| Medicare PECOS PAC ID | 0840223921 |
|---|---|
| Medicare Enrollment ID | O20050919000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306884812 | NPI | - | NPPES |
| 100740890A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Brandon A Conkling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134273378 PECOS PAC ID: 8820189616 Enrollment ID: I20070808000545 |
| Provider Name | Matt Blankenship |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902950165 PECOS PAC ID: 9133211428 Enrollment ID: I20070816000143 |
| Provider Name | Christian D Clark |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649223710 PECOS PAC ID: 4082627468 Enrollment ID: I20100903000246 |
| Provider Name | Gary L. Hills |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1730174012 PECOS PAC ID: 2961480884 Enrollment ID: I20100922001111 |
| Provider Name | Douglas B Kliewer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174518906 PECOS PAC ID: 9335127257 Enrollment ID: I20100927000055 |
| Provider Name | Markham L Nightengale |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144215971 PECOS PAC ID: 6901830025 Enrollment ID: I20100927000063 |
| Provider Name | Patrick R Volak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174518336 PECOS PAC ID: 5496733313 Enrollment ID: I20100927000074 |
| Provider Name | Paul Stanton |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407841794 PECOS PAC ID: 7416935333 Enrollment ID: I20101008000629 |
| Provider Name | Madelyn Mabry Keck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922000280 PECOS PAC ID: 8022205608 Enrollment ID: I20101208000762 |
| Provider Name | Tuesday Dawn Guthery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902248131 PECOS PAC ID: 9234373887 Enrollment ID: I20130920000319 |
| Provider Name | Jeffery J Blonsky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609896596 PECOS PAC ID: 4880881861 Enrollment ID: I20140625000783 |
| Provider Name | Kevin M Mcnamara |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770744575 PECOS PAC ID: 9133344880 Enrollment ID: I20140714000786 |
| Provider Name | Maryanne K Bolt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912378050 PECOS PAC ID: 8921318684 Enrollment ID: I20151109001343 |
| Provider Name | Aatish M Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154611457 PECOS PAC ID: 6507098118 Enrollment ID: I20170905002638 |
| Provider Name | Jonathan Daniel Bouldin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447735055 PECOS PAC ID: 7012252190 Enrollment ID: I20181218001495 |
| Provider Name | Candy S Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124483482 PECOS PAC ID: 8224463294 Enrollment ID: I20200122000054 |
| Provider Name | Matthew Hillis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871184911 PECOS PAC ID: 0143612929 Enrollment ID: I20220128001105 |
| Provider Name | Dushyant Singh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598780660 PECOS PAC ID: 9032263397 Enrollment ID: I20231214003176 |
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