| Bedside Manner Llc | |
|
550 W 125th Pl S Ste 202 Glenpool OK 74033-5023 | |
| (918) 528-5500 | |
| (918) 372-9254 |
| Full Name | Bedside Manner Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 550 W 125th Pl S Ste 202, Glenpool, Oklahoma |
| Authorized Official Name and Position | Travis Wolff (CEO) |
| Authorized Official Contact | 9185285500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bedside Manner Llc 550 W 125th Pl S Ste 202 Glenpool OK 74033-5023 Ph: () - | Bedside Manner Llc 550 W 125th Pl S Ste 202 Glenpool OK 74033-5023 Ph: (918) 528-5500 |
| NPI Number | 1336983899 |
|---|---|
| Provider Enumeration Date | 06/20/2024 |
| Last Update Date | 01/21/2025 |
| Medicare PECOS PAC ID | 7719423250 |
|---|---|
| Medicare Enrollment ID | O20240722000589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336983899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Theron Joseph Bliss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538364245 PECOS PAC ID: 0446420459 Enrollment ID: I20110831000235 |
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