| Caldwell Medical Group, Pllc | |
|
2109 S Highway 69 Wagoner OK 74467-9310 | |
| (918) 485-6069 | |
| (888) 815-0475 |
| Full Name | Caldwell Medical Group, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2109 S Highway 69, Wagoner, Oklahoma |
| Authorized Official Name and Position | Kammie Caldwell (PHYSICIAN / OWNER) |
| Authorized Official Contact | 9184852104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caldwell Medical Group, Pllc 2109 S Highway 69 Wagoner OK 74467-9310 Ph: (918) 485-6069 | Caldwell Medical Group, Pllc 2109 S Highway 69 Wagoner OK 74467-9310 Ph: (918) 485-6069 |
| NPI Number | 1760700371 |
|---|---|
| Provider Enumeration Date | 05/06/2010 |
| Last Update Date | 07/28/2023 |
| Medicare PECOS PAC ID | 2860441300 |
|---|---|
| Medicare Enrollment ID | O20050121000515 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760700371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kammie M Caldwell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780663575 PECOS PAC ID: 1951350461 Enrollment ID: I20050121000242 |
| Provider Name | Christa Sabrina Mckellar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295329795 PECOS PAC ID: 1557331642 Enrollment ID: I20210805001128 |
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