| Choctaw Nation Health Care | |
|
1 Choctaw Way Talihina OK 74571-2022 | |
| (918) 567-7000 | |
| (918) 567-7041 |
| Full Name | Choctaw Nation Health Care |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1 Choctaw Way, Talihina, Oklahoma |
| Authorized Official Name and Position | Teresa Kay Jackson (CEO) |
| Authorized Official Contact | 9185677000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Choctaw Nation Health Care 1 Choctaw Way Talihina OK 74571-2022 Ph: (918) 567-7000 | Choctaw Nation Health Care 1 Choctaw Way Talihina OK 74571-2022 Ph: (918) 567-7000 |
| NPI Number | 1659347623 |
|---|---|
| Provider Enumeration Date | 02/28/2006 |
| Last Update Date | 01/12/2024 |
| Medicare PECOS PAC ID | 1759294838 |
|---|---|
| Medicare Enrollment ID | O20031106000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659347623 | NPI | - | NPPES |
| 100699600C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Secondary |
| 282NR1301X | General Acute Care Hospital - Rural | (* (Not Available)) | Primary |
| Provider Name | Steven O Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083682108 PECOS PAC ID: 8820901721 Enrollment ID: I20031106000790 |
| Provider Name | Joel D Rosen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134191364 PECOS PAC ID: 1153225362 Enrollment ID: I20031120000389 |
| Provider Name | Marie Carol Cole |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861464331 PECOS PAC ID: 2365342599 Enrollment ID: I20040112000568 |
| Provider Name | Olin W Fenton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164416574 PECOS PAC ID: 5395639702 Enrollment ID: I20040209000345 |
| Provider Name | Regan Michelle Welch |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205856630 PECOS PAC ID: 9335035245 Enrollment ID: I20040226000844 |
| Provider Name | Dee D Baughman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871566083 PECOS PAC ID: 3577454768 Enrollment ID: I20040324001670 |
| Provider Name | Gloria Grim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942299276 PECOS PAC ID: 7911993340 Enrollment ID: I20040421001863 |
| Provider Name | Robert Anthony |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598892309 PECOS PAC ID: 8123018967 Enrollment ID: I20040514000193 |
| Provider Name | Carolyn J. Mcdougald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902887755 PECOS PAC ID: 6305829003 Enrollment ID: I20040612000062 |
| Provider Name | Derek J Melton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922058429 PECOS PAC ID: 7315924081 Enrollment ID: I20040630000914 |
| Provider Name | Shiela D Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013975523 PECOS PAC ID: 0840270740 Enrollment ID: I20040721001542 |
| Provider Name | Charles T Whittenburg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073531158 PECOS PAC ID: 1052382140 Enrollment ID: I20040806000117 |
| Provider Name | Suzan M Abeyta |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861672743 PECOS PAC ID: 3678545670 Enrollment ID: I20040810001111 |
| Provider Name | Stephen Fransen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1750358107 PECOS PAC ID: 3971576935 Enrollment ID: I20040817001200 |
| Provider Name | Larry L Ellis |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1972572576 PECOS PAC ID: 6608842166 Enrollment ID: I20040907000340 |
| Provider Name | Imad Alwan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811931512 PECOS PAC ID: 6406815463 Enrollment ID: I20041005001259 |
| Provider Name | Willys L Lamb |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1336113026 PECOS PAC ID: 3476512922 Enrollment ID: I20041008000923 |
| Provider Name | Benjamin C Thompson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639147093 PECOS PAC ID: 0345209896 Enrollment ID: I20041008000967 |
| Provider Name | Michael C West |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881655678 PECOS PAC ID: 6709845282 Enrollment ID: I20041008001221 |
| Provider Name | Nicole Diane Williams |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1164502100 PECOS PAC ID: 8820058746 Enrollment ID: I20041014001222 |
| Provider Name | Ada J Canaday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982724712 PECOS PAC ID: 7810975000 Enrollment ID: I20041113000259 |
| Provider Name | George A Stephen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518064997 PECOS PAC ID: 7214991124 Enrollment ID: I20041118001141 |
| Provider Name | Danny Silver |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972582260 PECOS PAC ID: 6406814672 Enrollment ID: I20041221000203 |
| Provider Name | Benjamin James Williams |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396721460 PECOS PAC ID: 5698725331 Enrollment ID: I20050201000190 |
| Provider Name | Erin C Adams |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801064589 PECOS PAC ID: 7315986437 Enrollment ID: I20050428000336 |
| Provider Name | David Wilkett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922080860 PECOS PAC ID: 1557304383 Enrollment ID: I20050602001036 |
| Provider Name | Timothy T Mccay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245221761 PECOS PAC ID: 2961456538 Enrollment ID: I20050621000935 |
| Provider Name | Dean Roy Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770574253 PECOS PAC ID: 5193710929 Enrollment ID: I20050712000568 |
| Provider Name | Barbara Howell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093788085 PECOS PAC ID: 1850327792 Enrollment ID: I20050712001234 |
| Provider Name | Sheila Malone Taber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447241971 PECOS PAC ID: 1557311495 Enrollment ID: I20050715000344 |
| Provider Name | George E Erbacher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326039801 PECOS PAC ID: 5991755829 Enrollment ID: I20050720000214 |
| Provider Name | Felino A Pascual |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801877055 PECOS PAC ID: 6002801834 Enrollment ID: I20050728000628 |
| Provider Name | John S Dennis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871584060 PECOS PAC ID: 3173594389 Enrollment ID: I20050728000739 |
| Provider Name | Stepanka Baggett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881618742 PECOS PAC ID: 0648253930 Enrollment ID: I20050728000913 |
| Provider Name | Gregory Pineau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114035334 PECOS PAC ID: 3476542358 Enrollment ID: I20050808001252 |
| Provider Name | Shannon Patrick Calhoun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598715278 PECOS PAC ID: 7911804398 Enrollment ID: I20050826000631 |
| Provider Name | Mike P Martin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639137516 PECOS PAC ID: 3274565981 Enrollment ID: I20050901000944 |
| Provider Name | Thomas C Bonin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215902358 PECOS PAC ID: 3779509930 Enrollment ID: I20051018000579 |
| Provider Name | Abraham Jacob |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679513626 PECOS PAC ID: 2466479787 Enrollment ID: I20051026000803 |
| Provider Name | Virginia Vittor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962558197 PECOS PAC ID: 0244251239 Enrollment ID: I20051219000440 |
| Provider Name | Muhammad A Sattar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760465553 PECOS PAC ID: 8022031715 Enrollment ID: I20060109000636 |
| Provider Name | Glenn Waite |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295742948 PECOS PAC ID: 9133019086 Enrollment ID: I20060428000100 |
| Provider Name | John D Walton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326096850 PECOS PAC ID: 3375546054 Enrollment ID: I20060907000113 |
| Provider Name | Jo-ann Rosenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831126853 PECOS PAC ID: 6608870191 Enrollment ID: I20060914000633 |
| Provider Name | Karen A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700804374 PECOS PAC ID: 9032114541 Enrollment ID: I20060915000260 |
| Provider Name | Michael S. Krischer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1093737546 PECOS PAC ID: 5799676508 Enrollment ID: I20061107000302 |
| Provider Name | Gerald P Heisler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245310168 PECOS PAC ID: 8325049448 Enrollment ID: I20070116000375 |
| Provider Name | Myeong S Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497722342 PECOS PAC ID: 0042227266 Enrollment ID: I20070219000272 |
| Provider Name | Carla Huckabee |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1548339567 PECOS PAC ID: 2961437033 Enrollment ID: I20070319000102 |
| Provider Name | David Scott James |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346282316 PECOS PAC ID: 0547237679 Enrollment ID: I20070404000592 |
| Provider Name | Debasish Chaudhuri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811927833 PECOS PAC ID: 7618074709 Enrollment ID: I20070829000902 |
| Provider Name | Sarah A Owers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407825847 PECOS PAC ID: 3971585654 Enrollment ID: I20070911000724 |
| Provider Name | Larry H Pittman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003014077 PECOS PAC ID: 4587759956 Enrollment ID: I20070929000079 |
| Provider Name | Margaret Bailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841283348 PECOS PAC ID: 3274436928 Enrollment ID: I20071002000768 |
| Provider Name | Alexander A Pleszynski-platz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1285790147 PECOS PAC ID: 8426096454 Enrollment ID: I20071013000041 |
| Provider Name | Lisa D Ortiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275743684 PECOS PAC ID: 6406946946 Enrollment ID: I20071220000196 |
| Provider Name | David W Young |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427006832 PECOS PAC ID: 9739144122 Enrollment ID: I20080115000660 |
| Provider Name | Anwar Barnouti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871791392 PECOS PAC ID: 3173605011 Enrollment ID: I20080130000572 |
| Provider Name | Johnny R Rodriguez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457390056 PECOS PAC ID: 0244290864 Enrollment ID: I20080130000677 |
| Provider Name | Paul Chin |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1235103151 PECOS PAC ID: 3870676497 Enrollment ID: I20080205000687 |
| Provider Name | Oluyemisi J Fatunde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457359663 PECOS PAC ID: 4688663966 Enrollment ID: I20080225000662 |
| Provider Name | William Justin Hayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891735098 PECOS PAC ID: 4981683851 Enrollment ID: I20080917000706 |
| Provider Name | Laura L Arrowsmith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083654800 PECOS PAC ID: 9638123631 Enrollment ID: I20081014000674 |
| Provider Name | Jose Jesus Gomez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427083351 PECOS PAC ID: 6406949387 Enrollment ID: I20081023000157 |
| Provider Name | Judith Wolfstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013914456 PECOS PAC ID: 0345135232 Enrollment ID: I20081203000298 |
| Provider Name | Dale Baughman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700048477 PECOS PAC ID: 1254492358 Enrollment ID: I20081208000607 |
| Provider Name | Douglas C Nolan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700893898 PECOS PAC ID: 6709949381 Enrollment ID: I20090107000656 |
| Provider Name | Cheryl D Tarver |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1043294994 PECOS PAC ID: 8820151285 Enrollment ID: I20090112000086 |
| Provider Name | Jason Pack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861549743 PECOS PAC ID: 3375623887 Enrollment ID: I20090305000362 |
| Provider Name | Christopher L Ward |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851530190 PECOS PAC ID: 3375609530 Enrollment ID: I20090313000109 |
| Provider Name | Ralph Noah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669458741 PECOS PAC ID: 6800966284 Enrollment ID: I20090326000463 |
| Provider Name | Hooby P Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508066473 PECOS PAC ID: 4486705779 Enrollment ID: I20090626000135 |
| Provider Name | Dakota S Waldroop |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346471711 PECOS PAC ID: 4486709359 Enrollment ID: I20090827000750 |
| Provider Name | Andrea N Mazzare |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720219470 PECOS PAC ID: 5597811752 Enrollment ID: I20090914000444 |
| Provider Name | Hana Teissler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417948803 PECOS PAC ID: 4688607559 Enrollment ID: I20090915000320 |
| Provider Name | Kelly Cole |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699958157 PECOS PAC ID: 0648322024 Enrollment ID: I20090916000496 |
| Provider Name | Jeremy Scott Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255537304 PECOS PAC ID: 5092867762 Enrollment ID: I20090917000124 |
| Provider Name | Damon L Brooks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558583963 PECOS PAC ID: 4587715354 Enrollment ID: I20090917000269 |
| Provider Name | Rodger Mattson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215999776 PECOS PAC ID: 9830091610 Enrollment ID: I20091002000309 |
| Provider Name | Kynan D Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497908495 PECOS PAC ID: 1850431446 Enrollment ID: I20091211000383 |
| Provider Name | Sharon K Little |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295727071 PECOS PAC ID: 9638136484 Enrollment ID: I20091230000457 |
| Provider Name | Tony A Little |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336131242 PECOS PAC ID: 8628971462 Enrollment ID: I20091230000604 |
| Provider Name | David B Glover |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760484117 PECOS PAC ID: 9739176439 Enrollment ID: I20100109000351 |
| Provider Name | Michael E Marvin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366483000 PECOS PAC ID: 3870544612 Enrollment ID: I20100219000450 |
| Provider Name | Nancy A Jefferson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619965662 PECOS PAC ID: 1254398399 Enrollment ID: I20100303000745 |
| Provider Name | Sara Jane Bartos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326254673 PECOS PAC ID: 1153458633 Enrollment ID: I20100415000574 |
| Provider Name | Patricia J Redhage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033132964 PECOS PAC ID: 3476556309 Enrollment ID: I20100423000053 |
| Provider Name | Michelle M Ponder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447399415 PECOS PAC ID: 4880787217 Enrollment ID: I20100428000166 |
| Provider Name | Michael Mason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821076126 PECOS PAC ID: 8123055803 Enrollment ID: I20100504000235 |
| Provider Name | Patrick Mason |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255318663 PECOS PAC ID: 3678500352 Enrollment ID: I20100505000999 |
| Provider Name | Christos Vassiliou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053567784 PECOS PAC ID: 8820120454 Enrollment ID: I20100719000117 |
| Provider Name | John B Hoskins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417103854 PECOS PAC ID: 0941325286 Enrollment ID: I20100910000106 |
| Provider Name | Luis M Taveras |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447298278 PECOS PAC ID: 3173420239 Enrollment ID: I20101108000151 |
| Provider Name | Grant N Corning |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033259114 PECOS PAC ID: 2466549712 Enrollment ID: I20101119000781 |
| Provider Name | Amanda G Chisum Price |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407047459 PECOS PAC ID: 1850488602 Enrollment ID: I20110221000113 |
| Provider Name | Pratap R Tummala |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1730187816 PECOS PAC ID: 0749371581 Enrollment ID: I20110303000915 |
| Provider Name | Bridget Walsh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568405207 PECOS PAC ID: 3274570015 Enrollment ID: I20110317000115 |
| Provider Name | Nina C Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003877754 PECOS PAC ID: 6901833367 Enrollment ID: I20110414000371 |
| Provider Name | Ryan D Magnus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174576292 PECOS PAC ID: 6204012032 Enrollment ID: I20110512000314 |
| Provider Name | Elizabeth M Feltner |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174611818 PECOS PAC ID: 5890785836 Enrollment ID: I20110606000284 |
| Provider Name | Eric S Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255562831 PECOS PAC ID: 8921147182 Enrollment ID: I20110606000551 |
| Provider Name | Stephen A Back |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639302060 PECOS PAC ID: 3476723594 Enrollment ID: I20110829000547 |
| Provider Name | Robert R King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801051370 PECOS PAC ID: 7719150085 Enrollment ID: I20111101000734 |
| Provider Name | Pedro Argoti Torres |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356623201 PECOS PAC ID: 9133392301 Enrollment ID: I20111103000406 |
| Provider Name | Phillip W Halcum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013972884 PECOS PAC ID: 8426225004 Enrollment ID: I20120123000504 |
| Provider Name | Jason L Hill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205806759 PECOS PAC ID: 9436110848 Enrollment ID: I20120206000893 |
| Provider Name | Jason K Regan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861466062 PECOS PAC ID: 7517124324 Enrollment ID: I20120207000356 |
| Provider Name | Jonathan A Doyle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003955204 PECOS PAC ID: 5890829824 Enrollment ID: I20120214000069 |
| Provider Name | Tyree L Seals |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477611564 PECOS PAC ID: 7719925502 Enrollment ID: I20120306000935 |
| Provider Name | Vinay A Shah |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1013951409 PECOS PAC ID: 2567513492 Enrollment ID: I20120313000984 |
| Provider Name | Dixie A Hammons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376510461 PECOS PAC ID: 2163683152 Enrollment ID: I20120419000042 |
| Provider Name | James Wilson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295990687 PECOS PAC ID: 8820163652 Enrollment ID: I20120606000440 |
| Provider Name | Jeri L Hargrave |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346240199 PECOS PAC ID: 6507848116 Enrollment ID: I20120606000455 |
| Provider Name | Hang T Vu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730140476 PECOS PAC ID: 7810921137 Enrollment ID: I20120628000668 |
| Provider Name | Lloyd W Sloan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750351136 PECOS PAC ID: 0244410231 Enrollment ID: I20120709000196 |
| Provider Name | Patrick B O Hayre |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518134352 PECOS PAC ID: 2264695402 Enrollment ID: I20120730000568 |
| Provider Name | Leila Danielle See |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013164268 PECOS PAC ID: 6800059064 Enrollment ID: I20120810000291 |
| Provider Name | Joaquin M Forbes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285863878 PECOS PAC ID: 5698921195 Enrollment ID: I20120816000599 |
| Provider Name | Jeffrey W Shelton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194864074 PECOS PAC ID: 7719141639 Enrollment ID: I20120823000396 |
| Provider Name | Akhtar Ali |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659400679 PECOS PAC ID: 1052373446 Enrollment ID: I20120910000189 |
| Provider Name | Nancy J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740396712 PECOS PAC ID: 4880610195 Enrollment ID: I20120911000166 |
| Provider Name | Lucinda L Sparks |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891071924 PECOS PAC ID: 6800040163 Enrollment ID: I20130214000189 |
| Provider Name | Koyippallil George Sachariah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285732826 PECOS PAC ID: 7012996408 Enrollment ID: I20130311000450 |
| Provider Name | Ian Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881985760 PECOS PAC ID: 9436328986 Enrollment ID: I20130605000496 |
| Provider Name | Bruce Randolph Tizes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588942379 PECOS PAC ID: 2163661281 Enrollment ID: I20130621000439 |
| Provider Name | Ty A Salness |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831132232 PECOS PAC ID: 1759384001 Enrollment ID: I20130624000083 |
| Provider Name | Tejaswi Bhari Thippeswamy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811189269 PECOS PAC ID: 1456521509 Enrollment ID: I20130624000298 |
| Provider Name | Jonathon D Kirkland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639315260 PECOS PAC ID: 4789823139 Enrollment ID: I20130726000027 |
| Provider Name | Eduardo Tan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033175930 PECOS PAC ID: 2062607591 Enrollment ID: I20130730000772 |
| Provider Name | James Loverde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598805616 PECOS PAC ID: 5799776530 Enrollment ID: I20130730000867 |
| Provider Name | John D Leever |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912149261 PECOS PAC ID: 0042473738 Enrollment ID: I20130807000187 |
| Provider Name | James N Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306089578 PECOS PAC ID: 4284876558 Enrollment ID: I20130911000061 |
| Provider Name | Joshua M Golden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255764387 PECOS PAC ID: 7113152513 Enrollment ID: I20131019000041 |
| Provider Name | Gary Dale Fine |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245231828 PECOS PAC ID: 8527956614 Enrollment ID: I20131023002044 |
| Provider Name | Maria Elaine Ramos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184853186 PECOS PAC ID: 0547418774 Enrollment ID: I20131106001132 |
| Provider Name | Gregory Claiborn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568627768 PECOS PAC ID: 1951570779 Enrollment ID: I20131217000374 |
| Provider Name | Chandra Nukala |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1770715591 PECOS PAC ID: 3476780453 Enrollment ID: I20131219000265 |
| Provider Name | Arpana Neupane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780993568 PECOS PAC ID: 8426285362 Enrollment ID: I20131220000704 |
| Provider Name | Yamini Atluri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700198595 PECOS PAC ID: 0143453308 Enrollment ID: I20140424000529 |
| Provider Name | Sheila G Simpson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619907144 PECOS PAC ID: 8325234925 Enrollment ID: I20140509001375 |
| Provider Name | John L Kareus |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033138821 PECOS PAC ID: 9739242140 Enrollment ID: I20140515001423 |
| Provider Name | Brooke White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558679035 PECOS PAC ID: 4688807464 Enrollment ID: I20140516000548 |
| Provider Name | Michael J Golden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952527012 PECOS PAC ID: 9032353313 Enrollment ID: I20140701000579 |
| Provider Name | Paul K Howell |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1063431328 PECOS PAC ID: 0446390850 Enrollment ID: I20140815001557 |
| Provider Name | Keerth Surakanti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104116110 PECOS PAC ID: 1254558190 Enrollment ID: I20140815002193 |
| Provider Name | Nicholas Bull |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487968756 PECOS PAC ID: 6507099389 Enrollment ID: I20140821001827 |
| Provider Name | Peter J Mostert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326346875 PECOS PAC ID: 2860635844 Enrollment ID: I20140828001578 |
| Provider Name | Cody W Mccorkle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780977009 PECOS PAC ID: 3577715606 Enrollment ID: I20140904001488 |
| Provider Name | Bo Yon Choi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053551721 PECOS PAC ID: 5890920870 Enrollment ID: I20140925002205 |
| Provider Name | Kelly K Boucher |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528476207 PECOS PAC ID: 1456571017 Enrollment ID: I20141001002687 |
| Provider Name | Alan Dean Flanagan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780672170 PECOS PAC ID: 8820066103 Enrollment ID: I20141010000397 |
| Provider Name | Jeffrey M Spear |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477528776 PECOS PAC ID: 0042100133 Enrollment ID: I20141114001456 |
| Provider Name | Anthony S Battese |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710396965 PECOS PAC ID: 2365764388 Enrollment ID: I20141202002207 |
| Provider Name | Laura L Williams Thomas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679615942 PECOS PAC ID: 6507188299 Enrollment ID: I20141209000235 |
| Provider Name | Reed K Burk |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1023013760 PECOS PAC ID: 6901854579 Enrollment ID: I20141223001452 |
| Provider Name | April Dawn Whitacre |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003219379 PECOS PAC ID: 5597088427 Enrollment ID: I20141230001518 |
| Provider Name | Anil Kumar Goli |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1629013008 PECOS PAC ID: 0941193635 Enrollment ID: I20150114001208 |
| Provider Name | David J Ingle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700884491 PECOS PAC ID: 4688561368 Enrollment ID: I20150116001899 |
| Provider Name | Masoud Moradi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1942580139 PECOS PAC ID: 2466694732 Enrollment ID: I20150122001589 |
| Provider Name | Kimberly A Abernethy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235210048 PECOS PAC ID: 9931374428 Enrollment ID: I20150211000700 |
| Provider Name | Samantha Chandler Herbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598154288 PECOS PAC ID: 4284959917 Enrollment ID: I20150220001146 |
| Provider Name | Rachelle Ladawn Bradford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316336399 PECOS PAC ID: 2961728613 Enrollment ID: I20150224001712 |
| Provider Name | James S Deneke |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1689605784 PECOS PAC ID: 2466592878 Enrollment ID: I20150320001336 |
| Provider Name | Jared Chase Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295131233 PECOS PAC ID: 1052638392 Enrollment ID: I20150325000315 |
| Provider Name | Myra A Gregory |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669439899 PECOS PAC ID: 7113909177 Enrollment ID: I20150514001279 |
| Provider Name | Kyle G Flowers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063710580 PECOS PAC ID: 2769703107 Enrollment ID: I20150610001387 |
| Provider Name | Tanakorn Songrug |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073847455 PECOS PAC ID: 7416184478 Enrollment ID: I20150615002064 |
| Provider Name | Donald Von Borstel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275887663 PECOS PAC ID: 3779894860 Enrollment ID: I20150617001059 |
| Provider Name | Jeffrey Joseph Zipparo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699113118 PECOS PAC ID: 9638305998 Enrollment ID: I20150622000762 |
| Provider Name | Mark R Faber |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831172071 PECOS PAC ID: 3173835295 Enrollment ID: I20150702000899 |
| Provider Name | Zenab Olajumoke Jaji-drew |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154611911 PECOS PAC ID: 7012221112 Enrollment ID: I20150803002396 |
| Provider Name | David P Sparling |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588807879 PECOS PAC ID: 9133430580 Enrollment ID: I20150904001178 |
| Provider Name | Marcus Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275776965 PECOS PAC ID: 8224250816 Enrollment ID: I20150910000185 |
| Provider Name | Jane Laroche |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902820079 PECOS PAC ID: 5890726335 Enrollment ID: I20151006000510 |
| Provider Name | Marco A Trigueros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114286697 PECOS PAC ID: 0042528283 Enrollment ID: I20151007002545 |
| Provider Name | Michael H Arredondo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558574574 PECOS PAC ID: 2668518796 Enrollment ID: I20151026000808 |
| Provider Name | Sirpa T Autio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134158405 PECOS PAC ID: 9234121377 Enrollment ID: I20151026002601 |
| Provider Name | Christopher Van Asche |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881603264 PECOS PAC ID: 6709863921 Enrollment ID: I20151105000292 |
| Provider Name | Vu A Ngo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437565116 PECOS PAC ID: 6507176922 Enrollment ID: I20151113001338 |
| Provider Name | Elizabeth C Hines |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962679142 PECOS PAC ID: 2062681885 Enrollment ID: I20151114000021 |
| Provider Name | Jaclyn D Rouse |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063898161 PECOS PAC ID: 5991005050 Enrollment ID: I20151123001529 |
| Provider Name | Ashton B Clayborn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194112839 PECOS PAC ID: 0840591830 Enrollment ID: I20151216001486 |
| Provider Name | Susan S Wexler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598844532 PECOS PAC ID: 0446486385 Enrollment ID: I20151217000335 |
| Provider Name | Bryan C Spears |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518166347 PECOS PAC ID: 5395839617 Enrollment ID: I20151218000504 |
| Provider Name | Janice Yuchin Kao |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497869390 PECOS PAC ID: 3375867203 Enrollment ID: I20160111002175 |
| Provider Name | Michael Knowland |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1477574887 PECOS PAC ID: 8921042094 Enrollment ID: I20160222002020 |
| Provider Name | Nicholas T Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679695548 PECOS PAC ID: 4587758206 Enrollment ID: I20160322001642 |
| Provider Name | Grace Nguyen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063771319 PECOS PAC ID: 3971741596 Enrollment ID: I20160405000504 |
| Provider Name | Andrew B Emmerman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265690697 PECOS PAC ID: 6507933751 Enrollment ID: I20160414000195 |
| Provider Name | Dwala M Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346628088 PECOS PAC ID: 3274822630 Enrollment ID: I20160525001521 |
| Provider Name | Courtney Marie Trent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841544566 PECOS PAC ID: 3678864451 Enrollment ID: I20160627000227 |
| Provider Name | Jennifer Michelle Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154704401 PECOS PAC ID: 7719278431 Enrollment ID: I20160627001865 |
| Provider Name | Breck Layne Bennett |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568572394 PECOS PAC ID: 3072804772 Enrollment ID: I20160628001718 |
| Provider Name | George Polanco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326019332 PECOS PAC ID: 0244210755 Enrollment ID: I20160713002114 |
| Provider Name | Roberta Irene Neely |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063693521 PECOS PAC ID: 3173817301 Enrollment ID: I20160810000946 |
| Provider Name | Michael P Cotter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295755577 PECOS PAC ID: 0446295943 Enrollment ID: I20160827000252 |
| Provider Name | Jennifer Dillard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457734063 PECOS PAC ID: 2961798293 Enrollment ID: I20160912002604 |
| Provider Name | Mark M Jackson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144391525 PECOS PAC ID: 0749321776 Enrollment ID: I20161019001850 |
| Provider Name | Frederick Murray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932462660 PECOS PAC ID: 9739317926 Enrollment ID: I20161025001747 |
| Provider Name | Allen Dale Baughman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962875922 PECOS PAC ID: 6709164395 Enrollment ID: I20161102001938 |
| Provider Name | Jeanette Cserna-kinion |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346263225 PECOS PAC ID: 2264735141 Enrollment ID: I20161114001717 |
| Provider Name | Ronald A Stillerman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679549166 PECOS PAC ID: 7214958370 Enrollment ID: I20161122000168 |
| Provider Name | Cedana Lanig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194179457 PECOS PAC ID: 7719266386 Enrollment ID: I20161123000144 |
| Provider Name | Natasha Bray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285840660 PECOS PAC ID: 2163516881 Enrollment ID: I20161123000368 |
| Provider Name | Olen Jestis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578794087 PECOS PAC ID: 3476677949 Enrollment ID: I20161128001471 |
| Provider Name | Debra Hefner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720308570 PECOS PAC ID: 5991085805 Enrollment ID: I20161212002118 |
| Provider Name | Sarah Wade |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144533241 PECOS PAC ID: 5890983928 Enrollment ID: I20161214002218 |
| Provider Name | Kishore Gaddam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093069411 PECOS PAC ID: 4284957390 Enrollment ID: I20161214002549 |
| Provider Name | Adam Waldon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831643287 PECOS PAC ID: 1850671413 Enrollment ID: I20161217000143 |
| Provider Name | Jim Harjo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194746776 PECOS PAC ID: 1850353210 Enrollment ID: I20161217000182 |
| Provider Name | Cynthia Ashcraft |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306833215 PECOS PAC ID: 4688634645 Enrollment ID: I20161219001569 |
| Provider Name | Lija L Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891135125 PECOS PAC ID: 3779807300 Enrollment ID: I20161219002084 |
| Provider Name | Kurt Zimmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104866029 PECOS PAC ID: 9335163666 Enrollment ID: I20161221001413 |
| Provider Name | Kelly Andrzejczyk-beatty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598083172 PECOS PAC ID: 1456572601 Enrollment ID: I20161222000372 |
| Provider Name | Ann Mciver |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275501033 PECOS PAC ID: 0244125623 Enrollment ID: I20170104000409 |
| Provider Name | Robert Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336137728 PECOS PAC ID: 4385692938 Enrollment ID: I20170104001325 |
| Provider Name | Laurie Montague |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326030099 PECOS PAC ID: 8527950039 Enrollment ID: I20170110002044 |
| Provider Name | Yves Laventure |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538299425 PECOS PAC ID: 9436295953 Enrollment ID: I20170118000468 |
| Provider Name | Arvind Gopal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346382082 PECOS PAC ID: 7416134937 Enrollment ID: I20170118000848 |
| Provider Name | Kimberly Holding |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528022431 PECOS PAC ID: 5496798167 Enrollment ID: I20170120002247 |
| Provider Name | Sarah Mccutcheon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902349111 PECOS PAC ID: 0648552893 Enrollment ID: I20170123002525 |
| Provider Name | Mary Bogen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1649288663 PECOS PAC ID: 0042112237 Enrollment ID: I20170124000843 |
| Provider Name | Jason Seiter |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396808473 PECOS PAC ID: 3779677026 Enrollment ID: I20170202001747 |
| Provider Name | Bart M Rowlett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104945526 PECOS PAC ID: 5092602102 Enrollment ID: I20170215002368 |
| Provider Name | Saba Yousefian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952667115 PECOS PAC ID: 6204119506 Enrollment ID: I20170308001524 |
| Provider Name | James Sumner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396747168 PECOS PAC ID: 4688561343 Enrollment ID: I20170309000307 |
| Provider Name | Rochelle Grant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487092888 PECOS PAC ID: 8022302157 Enrollment ID: I20170309000512 |
| Provider Name | Jeffrey Raines |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700259710 PECOS PAC ID: 0547549685 Enrollment ID: I20170309002387 |
| Provider Name | Mary Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700801891 PECOS PAC ID: 6002191020 Enrollment ID: I20170314000354 |
| Provider Name | Sindhura Alapati |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528370319 PECOS PAC ID: 7012220189 Enrollment ID: I20170315001813 |
| Provider Name | You Lu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1780663906 PECOS PAC ID: 1951388271 Enrollment ID: I20170321001105 |
| Provider Name | Kesi T Kindle-suersin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528035268 PECOS PAC ID: 9931170164 Enrollment ID: I20170327001306 |
| Provider Name | Antonio Lopez-canino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821275470 PECOS PAC ID: 7416232723 Enrollment ID: I20170329001977 |
| Provider Name | Rye Garrels |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699872341 PECOS PAC ID: 5193724169 Enrollment ID: I20170418000094 |
| Provider Name | Emad Hamid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457553588 PECOS PAC ID: 7618021999 Enrollment ID: I20170502001404 |
| Provider Name | Maika T Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891134243 PECOS PAC ID: 8729365259 Enrollment ID: I20170510000175 |
| Provider Name | Kenneth E Mann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851398713 PECOS PAC ID: 7113985441 Enrollment ID: I20170519000382 |
| Provider Name | Jacqueline Anne Woodrum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285642199 PECOS PAC ID: 7012801426 Enrollment ID: I20170607002008 |
| Provider Name | Gilbert E Flores |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760516314 PECOS PAC ID: 5890737746 Enrollment ID: I20170616000441 |
| Provider Name | Diane Ridley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588643746 PECOS PAC ID: 1052342482 Enrollment ID: I20170620001389 |
| Provider Name | Blake Edward Weaver |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497785893 PECOS PAC ID: 6103890975 Enrollment ID: I20170629001468 |
| Provider Name | Antonia M Turner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518926674 PECOS PAC ID: 6800165127 Enrollment ID: I20170629002757 |
| Provider Name | Saurabh Chetankumar Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003226531 PECOS PAC ID: 3173813391 Enrollment ID: I20170802002941 |
| Provider Name | Anne Remy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841715240 PECOS PAC ID: 7911279112 Enrollment ID: I20170823002218 |
| Provider Name | Charlene Lohner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912267600 PECOS PAC ID: 6305083437 Enrollment ID: I20170906000364 |
| Provider Name | Joey V Louis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124385273 PECOS PAC ID: 3779854104 Enrollment ID: I20170906001023 |
| Provider Name | Arturo Federico |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205209228 PECOS PAC ID: 0345520391 Enrollment ID: I20170929001079 |
| Provider Name | Tracy Wilkerson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952517732 PECOS PAC ID: 2062605710 Enrollment ID: I20171005000399 |
| Provider Name | Donna Lukasek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740278076 PECOS PAC ID: 4082682422 Enrollment ID: I20171005002013 |
| Provider Name | Kevin L Hamm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578657623 PECOS PAC ID: 8022919620 Enrollment ID: I20171014000017 |
| Provider Name | Michael D. David |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003814179 PECOS PAC ID: 9830131275 Enrollment ID: I20171020000587 |
| Provider Name | Susan W Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992869721 PECOS PAC ID: 5395780365 Enrollment ID: I20171108003196 |
| Provider Name | Joseph Reed Hutchings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326559683 PECOS PAC ID: 0749546521 Enrollment ID: I20171110001078 |
| Provider Name | Kamekea Willis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235220302 PECOS PAC ID: 4789823550 Enrollment ID: I20171115001356 |
| Provider Name | Madhusudan Rao |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1780663849 PECOS PAC ID: 8325944739 Enrollment ID: I20171117001063 |
| Provider Name | Donald Brooks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790754281 PECOS PAC ID: 6800080979 Enrollment ID: I20171128001006 |
| Provider Name | Xuan Thao Nghe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073985073 PECOS PAC ID: 0143587253 Enrollment ID: I20171128002019 |
| Provider Name | Craig White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417278573 PECOS PAC ID: 2365757481 Enrollment ID: I20180104000432 |
| Provider Name | Nadia Crystal Crane |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1487164463 PECOS PAC ID: 3476812157 Enrollment ID: I20180126000409 |
| Provider Name | Brett Samuel Wallin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457557613 PECOS PAC ID: 9032303409 Enrollment ID: I20180206000927 |
| Provider Name | Kylah Clifft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790040350 PECOS PAC ID: 1456521137 Enrollment ID: I20180301002185 |
| Provider Name | Karen A Castellano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275725749 PECOS PAC ID: 1850464769 Enrollment ID: I20180312002493 |
| Provider Name | Nilma Malik |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1417340704 PECOS PAC ID: 7315267259 Enrollment ID: I20180319001686 |
| Provider Name | Mohammedali Hashmi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497208581 PECOS PAC ID: 4385910561 Enrollment ID: I20180320002776 |
| Provider Name | David Vincent Spencer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154820157 PECOS PAC ID: 1052673472 Enrollment ID: I20180323001202 |
| Provider Name | Daniel Rivera |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154465326 PECOS PAC ID: 7911187638 Enrollment ID: I20180409000200 |
| Provider Name | Olivia Danielle Reed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013380021 PECOS PAC ID: 0749543494 Enrollment ID: I20180411002718 |
| Provider Name | George Katsantonis |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1184610693 PECOS PAC ID: 3870553324 Enrollment ID: I20180521001844 |
| Provider Name | Natasha Estep |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1700383148 PECOS PAC ID: 7214292127 Enrollment ID: I20180524000746 |
| Provider Name | Natalia Solomon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003173915 PECOS PAC ID: 6709141328 Enrollment ID: I20180601001555 |
| Provider Name | David Wee Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699153627 PECOS PAC ID: 9335443324 Enrollment ID: I20180607001131 |
| Provider Name | Garima Gandhir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578859757 PECOS PAC ID: 4284855826 Enrollment ID: I20180611001055 |
| Provider Name | David Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841274321 PECOS PAC ID: 8820030836 Enrollment ID: I20180613000623 |
| Provider Name | Samuel B Hancock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063672608 PECOS PAC ID: 3577699073 Enrollment ID: I20180614000232 |
| Provider Name | Rosa L King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346393378 PECOS PAC ID: 6002097821 Enrollment ID: I20180615000465 |
| Provider Name | Barry P Kimberley |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1063417012 PECOS PAC ID: 5890773519 Enrollment ID: I20180621001663 |
| Provider Name | Robert K Beck |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1720177157 PECOS PAC ID: 2163475203 Enrollment ID: I20180702000420 |
| Provider Name | Julia D Knarreborg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952662363 PECOS PAC ID: 3173828803 Enrollment ID: I20180703001304 |
| Provider Name | Mark Sehgal |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801888441 PECOS PAC ID: 2062415110 Enrollment ID: I20180731000633 |
| Provider Name | Laura M Young |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720048267 PECOS PAC ID: 9436109477 Enrollment ID: I20180813001041 |
| Provider Name | Nathalie V Andry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992022305 PECOS PAC ID: 8921132903 Enrollment ID: I20180816000632 |
| Provider Name | Wilbur Lynn Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487934881 PECOS PAC ID: 1850524448 Enrollment ID: I20180820000729 |
| Provider Name | Alfred C Degner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891755294 PECOS PAC ID: 4082675996 Enrollment ID: I20180822000860 |
| Provider Name | Catherine Anne Shaeffer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811251499 PECOS PAC ID: 4385872175 Enrollment ID: I20180830000526 |
| Provider Name | Michael A Doyle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376957852 PECOS PAC ID: 5698066942 Enrollment ID: I20180904001071 |
| Provider Name | Steven Matthew Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366733404 PECOS PAC ID: 0042536575 Enrollment ID: I20180912003056 |
| Provider Name | Kyle F Summers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346663135 PECOS PAC ID: 6406119593 Enrollment ID: I20180926000466 |
| Provider Name | Frank J Seck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790777811 PECOS PAC ID: 3678654860 Enrollment ID: I20181003000247 |
| Provider Name | Tracy S Sanford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346356862 PECOS PAC ID: 3678653508 Enrollment ID: I20181003000252 |
| Provider Name | Aun Ali Hussain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184056202 PECOS PAC ID: 5092067439 Enrollment ID: I20181011002458 |
| Provider Name | Ronald Stephen Pritchard |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1417998774 PECOS PAC ID: 2668426578 Enrollment ID: I20181016001073 |
| Provider Name | Hanh Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811474539 PECOS PAC ID: 8729322847 Enrollment ID: I20181130000753 |
| Provider Name | Francis Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861640468 PECOS PAC ID: 8123293305 Enrollment ID: I20181203002883 |
| Provider Name | Jonathan David Meyer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164716874 PECOS PAC ID: 0840510871 Enrollment ID: I20181205001153 |
| Provider Name | Alexander Blaschke |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225415540 PECOS PAC ID: 2365786969 Enrollment ID: I20181210000902 |
| Provider Name | Shawn D Grant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043214497 PECOS PAC ID: 6204877079 Enrollment ID: I20181211000646 |
| Provider Name | Brian Ayres |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548613151 PECOS PAC ID: 4486940731 Enrollment ID: I20181220000941 |
| Provider Name | Haley Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003399940 PECOS PAC ID: 6709121551 Enrollment ID: I20181222000073 |
| Provider Name | Darci Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053824359 PECOS PAC ID: 9931468360 Enrollment ID: I20181222000265 |
| Provider Name | Kristy Meeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508308701 PECOS PAC ID: 5092083469 Enrollment ID: I20190205000330 |
| Provider Name | Laura A Sanford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932644002 PECOS PAC ID: 6305184847 Enrollment ID: I20190208000545 |
| Provider Name | Jeff M Audibert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407801723 PECOS PAC ID: 9234178252 Enrollment ID: I20190212002792 |
| Provider Name | William Akwasi Ankobiah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386661163 PECOS PAC ID: 2264339605 Enrollment ID: I20190218000606 |
| Provider Name | Rodrigo Torres |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952390189 PECOS PAC ID: 9638114218 Enrollment ID: I20190225000355 |
| Provider Name | Casey Woolsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023472446 PECOS PAC ID: 5890089205 Enrollment ID: I20190304002331 |
| Provider Name | John Palmer Pickens |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1184629099 PECOS PAC ID: 6204972672 Enrollment ID: I20190418000484 |
| Provider Name | Robert Pace |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861404220 PECOS PAC ID: 2365420486 Enrollment ID: I20190605000570 |
| Provider Name | Matthew Ross Phillips |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457619272 PECOS PAC ID: 0042503732 Enrollment ID: I20190610002036 |
| Provider Name | Michael J Walters |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962768341 PECOS PAC ID: 6901198951 Enrollment ID: I20190621000329 |
| Provider Name | Natosha Monfore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912343435 PECOS PAC ID: 6800129651 Enrollment ID: I20190709001084 |
| Provider Name | Heinz Nagel |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1821234592 PECOS PAC ID: 0143215426 Enrollment ID: I20190802000504 |
| Provider Name | Brent Evan Appleton |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1831292242 PECOS PAC ID: 2567528375 Enrollment ID: I20190821000057 |
| Provider Name | Rasna Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457765828 PECOS PAC ID: 5698056133 Enrollment ID: I20190827000172 |
| Provider Name | Douglas W Terry |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1952317596 PECOS PAC ID: 5294764163 Enrollment ID: I20190827003036 |
| Provider Name | Marie L Duan Meservy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699018424 PECOS PAC ID: 0749588374 Enrollment ID: I20190830002587 |
| Provider Name | Eugenio Erquiaga |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528005048 PECOS PAC ID: 6002947033 Enrollment ID: I20190923000256 |
| Provider Name | Jerry Donald Howard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669565552 PECOS PAC ID: 0749312544 Enrollment ID: I20191002001567 |
| Provider Name | Domenic Michael Canonico |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770551640 PECOS PAC ID: 9537178587 Enrollment ID: I20191004000387 |
| Provider Name | Prashant Kaushik |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1073615324 PECOS PAC ID: 9234039215 Enrollment ID: I20191115001101 |
| Provider Name | Nicholas A Strle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851703185 PECOS PAC ID: 4587999354 Enrollment ID: I20191115001941 |
| Provider Name | Bobby Don Priddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871097741 PECOS PAC ID: 2466884242 Enrollment ID: I20191115002235 |
| Provider Name | Cameron P Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831515287 PECOS PAC ID: 7214264449 Enrollment ID: I20191116000000 |
| Provider Name | Robert L Cirillo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356305973 PECOS PAC ID: 0840238994 Enrollment ID: I20191231001741 |
| Provider Name | Whitney Scantling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386143782 PECOS PAC ID: 8729349428 Enrollment ID: I20200122000476 |
| Provider Name | Hao Yang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376056580 PECOS PAC ID: 2860829553 Enrollment ID: I20200218002353 |
| Provider Name | Joshua Lowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679059406 PECOS PAC ID: 1850728460 Enrollment ID: I20200220001664 |
| Provider Name | Jeff Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073933289 PECOS PAC ID: 2567899552 Enrollment ID: I20200304001706 |
| Provider Name | Spring Maddox |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1538651104 PECOS PAC ID: 7416293923 Enrollment ID: I20200317000598 |
| Provider Name | Charles W Rutter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700992542 PECOS PAC ID: 9335242155 Enrollment ID: I20200327000491 |
| Provider Name | Casey L Humphries |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265458459 PECOS PAC ID: 2567482961 Enrollment ID: I20200403002014 |
| Provider Name | Zane Kalter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649280041 PECOS PAC ID: 5597929687 Enrollment ID: I20200403002187 |
| Provider Name | James Brigance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700383668 PECOS PAC ID: 5395174551 Enrollment ID: I20200409000845 |
| Provider Name | Duncan M Kovash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093334906 PECOS PAC ID: 8729418058 Enrollment ID: I20200428001107 |
| Provider Name | Michael C Friedle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730471749 PECOS PAC ID: 0244528529 Enrollment ID: I20200430002345 |
| Provider Name | Gulam Khan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528055001 PECOS PAC ID: 4183519812 Enrollment ID: I20200513002332 |
| Provider Name | David Fontaine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861523409 PECOS PAC ID: 8729419353 Enrollment ID: I20200514000492 |
| Provider Name | Mikako Kuga |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952536963 PECOS PAC ID: 1254752827 Enrollment ID: I20200608000665 |
| Provider Name | Mckinley C Lawson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104137181 PECOS PAC ID: 6103056759 Enrollment ID: I20200609000592 |
| Provider Name | Nabil A Yassa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467438911 PECOS PAC ID: 8729020839 Enrollment ID: I20200609000648 |
| Provider Name | Quinton Tieu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235587627 PECOS PAC ID: 0749602019 Enrollment ID: I20200616001224 |
| Provider Name | Spencer Baird |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033605167 PECOS PAC ID: 9335475011 Enrollment ID: I20200623001936 |
| Provider Name | Merrill Brent Miller |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1780709659 PECOS PAC ID: 1355763103 Enrollment ID: I20200624000346 |
| Provider Name | Scott D Kassing |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588672141 PECOS PAC ID: 4183675820 Enrollment ID: I20200629000354 |
| Provider Name | Christopher D Roman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033266838 PECOS PAC ID: 1850482761 Enrollment ID: I20200701000532 |
| Provider Name | Barbara A O'mara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528162039 PECOS PAC ID: 2264620848 Enrollment ID: I20200714001451 |
| Provider Name | Angela Charlton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740377761 PECOS PAC ID: 9830494509 Enrollment ID: I20200803003321 |
| Provider Name | Michael Cooper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225079452 PECOS PAC ID: 1456675057 Enrollment ID: I20200804000980 |
| Provider Name | Tammy Tandberg Willcox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174985170 PECOS PAC ID: 8820382724 Enrollment ID: I20200806000058 |
| Provider Name | Dustin W Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992155626 PECOS PAC ID: 8921423807 Enrollment ID: I20200810001684 |
| Provider Name | Andrea Neita |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578778387 PECOS PAC ID: 7012016397 Enrollment ID: I20200903000549 |
| Provider Name | Olivia Rae Hoylman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881219095 PECOS PAC ID: 5092134015 Enrollment ID: I20200924001742 |
| Provider Name | Tyler M Arkless |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235347154 PECOS PAC ID: 9537241245 Enrollment ID: I20200930001370 |
| Provider Name | Lyne Geneste |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760893440 PECOS PAC ID: 0446661862 Enrollment ID: I20201116001409 |
| Provider Name | Karrianne Lynn Moore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326378233 PECOS PAC ID: 2567504111 Enrollment ID: I20201211000032 |
| Provider Name | Asghar Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376070383 PECOS PAC ID: 2961771928 Enrollment ID: I20201214001895 |
| Provider Name | Daniel Clyde Cummings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538114889 PECOS PAC ID: 8123917382 Enrollment ID: I20210104001714 |
| Provider Name | Tina R Shah |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437310513 PECOS PAC ID: 3274836341 Enrollment ID: I20210106000843 |
| Provider Name | Eugene Kojo Oteng |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023466950 PECOS PAC ID: 1052647427 Enrollment ID: I20210113000331 |
| Provider Name | Hala Toubbeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477513075 PECOS PAC ID: 4486732880 Enrollment ID: I20210113003141 |
| Provider Name | Dimple Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306023809 PECOS PAC ID: 5991952178 Enrollment ID: I20210114000460 |
| Provider Name | Monica Kennedy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275911950 PECOS PAC ID: 2860705050 Enrollment ID: I20210209000159 |
| Provider Name | Jeffrey W Gerstel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205010600 PECOS PAC ID: 5991792079 Enrollment ID: I20210316001509 |
| Provider Name | James Stull |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437710977 PECOS PAC ID: 6103233747 Enrollment ID: I20210329000874 |
| Provider Name | Ranata Hatcher |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1891779674 PECOS PAC ID: 2567481302 Enrollment ID: I20210330000182 |
| Provider Name | Chester P Barton |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1437163987 PECOS PAC ID: 5092122838 Enrollment ID: I20210408001042 |
| Provider Name | Maria Elkins |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285010132 PECOS PAC ID: 2860813482 Enrollment ID: I20210419001800 |
| Provider Name | Lori Edwards |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1093154239 PECOS PAC ID: 3375786569 Enrollment ID: I20210422000647 |
| Provider Name | Karen F Neeley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609810563 PECOS PAC ID: 6901882067 Enrollment ID: I20210506002106 |
| Provider Name | Shaun Mccormick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679957609 PECOS PAC ID: 2769798917 Enrollment ID: I20210614001869 |
| Provider Name | Eric Allen Gillette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376104893 PECOS PAC ID: 4688075112 Enrollment ID: I20210622001844 |
| Provider Name | Kathleen Shattenkirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386295467 PECOS PAC ID: 2860801859 Enrollment ID: I20210628000292 |
| Provider Name | Matthew Bledsoe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295116721 PECOS PAC ID: 6608188024 Enrollment ID: I20210702000599 |
| Provider Name | Rafel Alvarez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215383005 PECOS PAC ID: 7618247586 Enrollment ID: I20210706000944 |
| Provider Name | Tyler Braaten |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134507957 PECOS PAC ID: 3577964352 Enrollment ID: I20210708000016 |
| Provider Name | Ashlie Lynn Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255917852 PECOS PAC ID: 5395147177 Enrollment ID: I20210715003952 |
| Provider Name | Payden Cloud |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639742059 PECOS PAC ID: 3072916881 Enrollment ID: I20210730000174 |
| Provider Name | Kristi Clukey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699723072 PECOS PAC ID: 8022020692 Enrollment ID: I20210824001849 |
| Provider Name | Elizabeth Richardson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275067902 PECOS PAC ID: 5294146650 Enrollment ID: I20210831000099 |
| Provider Name | Lena Nicole Eagle Road |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932685955 PECOS PAC ID: 9830595321 Enrollment ID: I20210908003801 |
| Provider Name | Michael Goldberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821150657 PECOS PAC ID: 1456240399 Enrollment ID: I20210914000968 |
| Provider Name | David Matthew Graff |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144635038 PECOS PAC ID: 9537424361 Enrollment ID: I20211004001715 |
| Provider Name | Catherine Chokuba-azum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821595646 PECOS PAC ID: 2466783246 Enrollment ID: I20211025002160 |
| Provider Name | Hind Neamah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992291827 PECOS PAC ID: 0143579185 Enrollment ID: I20211208001583 |
| Provider Name | Soumya Vempalle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134514896 PECOS PAC ID: 9032500392 Enrollment ID: I20211220002762 |
| Provider Name | Toni Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205283678 PECOS PAC ID: 2466873179 Enrollment ID: I20211230001209 |
| Provider Name | Robert Benjamin Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568089555 PECOS PAC ID: 8123419058 Enrollment ID: I20220103000568 |
| Provider Name | Amaya Basta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457589699 PECOS PAC ID: 0042434524 Enrollment ID: I20220118001954 |
| Provider Name | Fariba Amiri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851340194 PECOS PAC ID: 2769463470 Enrollment ID: I20220127000669 |
| Provider Name | Robert Cadogan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598767691 PECOS PAC ID: 8921084211 Enrollment ID: I20220202000710 |
| Provider Name | David Culver |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851318463 PECOS PAC ID: 6901827906 Enrollment ID: I20220211000044 |
| Provider Name | Melody Emerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184074528 PECOS PAC ID: 9032498050 Enrollment ID: I20220215000759 |
| Provider Name | James Maeda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538162854 PECOS PAC ID: 6305818972 Enrollment ID: I20220225000266 |
| Provider Name | Amit Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447564950 PECOS PAC ID: 9234322033 Enrollment ID: I20220302001409 |
| Provider Name | Robert Gary Kramer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285069500 PECOS PAC ID: 8921492232 Enrollment ID: I20220303000163 |
| Provider Name | Trisha Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811511835 PECOS PAC ID: 2567857279 Enrollment ID: I20220316000980 |
| Provider Name | Andrea Dawn Coley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750034021 PECOS PAC ID: 5092956805 Enrollment ID: I20220322000473 |
| Provider Name | Dustin W Cheney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225492606 PECOS PAC ID: 9133523418 Enrollment ID: I20220324000946 |
| Provider Name | Stormi Mcknight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386006120 PECOS PAC ID: 9830485002 Enrollment ID: I20220328001814 |
| Provider Name | Ronald Kingsley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1962471326 PECOS PAC ID: 2668510397 Enrollment ID: I20220411002024 |
| Provider Name | James Michael Du Pont |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902466006 PECOS PAC ID: 2668869447 Enrollment ID: I20220426000739 |
| Provider Name | Frank Hebroni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437509494 PECOS PAC ID: 0941609754 Enrollment ID: I20220706002718 |
| Provider Name | Nancy Emelife |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992124093 PECOS PAC ID: 6608298245 Enrollment ID: I20220708000678 |
| Provider Name | Natalie E Armijo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932246881 PECOS PAC ID: 7315922598 Enrollment ID: I20220723000303 |
| Provider Name | Linda Meehan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275527087 PECOS PAC ID: 5698721314 Enrollment ID: I20220913003070 |
| Provider Name | Gregory Bradley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881135804 PECOS PAC ID: 6608207824 Enrollment ID: I20221013000072 |
| Provider Name | Oliver Cvitanic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538267208 PECOS PAC ID: 2567490204 Enrollment ID: I20221205003181 |
| Provider Name | Debra Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871786376 PECOS PAC ID: 9436246162 Enrollment ID: I20221209001074 |
| Provider Name | Adrianna Nicole Brooks |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1790350585 PECOS PAC ID: 1254700180 Enrollment ID: I20221215000143 |
| Provider Name | Joseph Eble |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972766806 PECOS PAC ID: 9436205952 Enrollment ID: I20230102000149 |
| Provider Name | Rashad Mohamed Riazuddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851917363 PECOS PAC ID: 6507236882 Enrollment ID: I20230102000222 |
| Provider Name | Tyler Austin Mckinney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144802554 PECOS PAC ID: 0941685259 Enrollment ID: I20230104002166 |
| Provider Name | Henry Daniel Gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285214767 PECOS PAC ID: 8123498045 Enrollment ID: I20230110000968 |
| Provider Name | Hannah Faith White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568172807 PECOS PAC ID: 3072983881 Enrollment ID: I20230111002197 |
| Provider Name | Malinda Gail Pollard |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1275872582 PECOS PAC ID: 2860862638 Enrollment ID: I20230112001412 |
| Provider Name | Charity Stafford |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1922570480 PECOS PAC ID: 0547631350 Enrollment ID: I20230113000478 |
| Provider Name | Megan Brooke Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184297798 PECOS PAC ID: 6800267535 Enrollment ID: I20230117001979 |
| Provider Name | Jessica Arlene Vaughn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225268873 PECOS PAC ID: 1456722925 Enrollment ID: I20230119001719 |
| Provider Name | Kristi K Martin |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1669652582 PECOS PAC ID: 0143262998 Enrollment ID: I20230120000429 |
| Provider Name | Caroline Jalen Couch |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114569423 PECOS PAC ID: 2961873260 Enrollment ID: I20230125000268 |
| Provider Name | Megan Wesley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639636095 PECOS PAC ID: 0648641811 Enrollment ID: I20230126000242 |
| Provider Name | Charlene Alexandra Lyons |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1316431281 PECOS PAC ID: 5193196368 Enrollment ID: I20230126000285 |
| Provider Name | Peyton Joines |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720601461 PECOS PAC ID: 8729400916 Enrollment ID: I20230126001290 |
| Provider Name | David Prater |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629404686 PECOS PAC ID: 2668601097 Enrollment ID: I20230126002644 |
| Provider Name | Hannah E Tustin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871116723 PECOS PAC ID: 8820469968 Enrollment ID: I20230127000187 |
| Provider Name | Pepito V Ramos |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811666738 PECOS PAC ID: 9335510478 Enrollment ID: I20230127000297 |
| Provider Name | Robert Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932547544 PECOS PAC ID: 5193950871 Enrollment ID: I20230211000055 |
| Provider Name | Patrick Sharp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003494972 PECOS PAC ID: 8729451489 Enrollment ID: I20230227003034 |
| Provider Name | Devin Leslie |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265922264 PECOS PAC ID: 4789057803 Enrollment ID: I20230310000051 |
| Provider Name | Bethany Marie Patterson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497003404 PECOS PAC ID: 0648644260 Enrollment ID: I20230322002818 |
| Provider Name | Islam Fayed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316300320 PECOS PAC ID: 3072922806 Enrollment ID: I20230403000723 |
| Provider Name | Zachary Ryan Cruse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730767740 PECOS PAC ID: 2264807304 Enrollment ID: I20230404000257 |
| Provider Name | Patrick William Mcintosh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407435852 PECOS PAC ID: 2365817434 Enrollment ID: I20230404001731 |
| Provider Name | Shanell Ann Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538748975 PECOS PAC ID: 8325413289 Enrollment ID: I20230405002917 |
| Provider Name | Dean Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457434516 PECOS PAC ID: 1355448200 Enrollment ID: I20230414000275 |
| Provider Name | Christopher Sonnier |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1598732513 PECOS PAC ID: 6608877634 Enrollment ID: I20230613000200 |
| Provider Name | Britney Speer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235883315 PECOS PAC ID: 4789042391 Enrollment ID: I20230614000426 |
| Provider Name | Austin Marsh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346773850 PECOS PAC ID: 7911389002 Enrollment ID: I20230624000094 |
| Provider Name | Laurian Duncan |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1649244559 PECOS PAC ID: 3375672744 Enrollment ID: I20230628000056 |
| Provider Name | Isaac Stacy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306520929 PECOS PAC ID: 8325407828 Enrollment ID: I20230630001665 |
| Provider Name | Mehyar Hefazi Torghabeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548655343 PECOS PAC ID: 9830586767 Enrollment ID: I20230701000263 |
| Provider Name | Crystal Helena Goree |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083283956 PECOS PAC ID: 1456711662 Enrollment ID: I20230720000307 |
| Provider Name | Christy Leah Mitchell |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1407324635 PECOS PAC ID: 6204298136 Enrollment ID: I20230809002847 |
| Provider Name | Bailey Buck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457978934 PECOS PAC ID: 1850708280 Enrollment ID: I20230810000358 |
| Provider Name | Logan Shelton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679184295 PECOS PAC ID: 3870912165 Enrollment ID: I20230810001409 |
| Provider Name | Gail J Schumacher |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1932355773 PECOS PAC ID: 8527134576 Enrollment ID: I20230824001399 |
| Provider Name | Heather Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417949744 PECOS PAC ID: 0244364602 Enrollment ID: I20230829002074 |
| Provider Name | Kaylyn Nicole Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760176861 PECOS PAC ID: 8325401912 Enrollment ID: I20230830000972 |
| Provider Name | Iman Qaiser |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1972098242 PECOS PAC ID: 6406104652 Enrollment ID: I20230912000672 |
| Provider Name | Aubrey J Slaughter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851596936 PECOS PAC ID: 4486898145 Enrollment ID: I20230913000750 |
| Provider Name | Oyinkansola Awodiya |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518596071 PECOS PAC ID: 6709240138 Enrollment ID: I20230918002963 |
| Provider Name | Sterling A Webb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184286296 PECOS PAC ID: 5496123473 Enrollment ID: I20231017003298 |
| Provider Name | Nita Kay Pipkin |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922250406 PECOS PAC ID: 6507212313 Enrollment ID: I20231031002346 |
| Provider Name | Raina Ann Sparks |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1245473032 PECOS PAC ID: 8628424389 Enrollment ID: I20231101000876 |
| Provider Name | Andrew Hale |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851786412 PECOS PAC ID: 6507266558 Enrollment ID: I20231209000539 |
| Provider Name | Amabel Varghese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962068171 PECOS PAC ID: 8527435585 Enrollment ID: I20231214000384 |
| Provider Name | Erin M Horsley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134405939 PECOS PAC ID: 2668786039 Enrollment ID: I20240103000811 |
| Provider Name | Kimberly S Winsor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447678016 PECOS PAC ID: 7517221948 Enrollment ID: I20240103001136 |
| Provider Name | Jessica Millsap |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710207451 PECOS PAC ID: 1759527559 Enrollment ID: I20240103003939 |
| Provider Name | Margaret Barber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245654052 PECOS PAC ID: 1658723358 Enrollment ID: I20240118001375 |
| Provider Name | Leah Lynn Turner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568706018 PECOS PAC ID: 3274985874 Enrollment ID: I20240119000325 |
| Provider Name | Martha Barber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669754412 PECOS PAC ID: 7517319056 Enrollment ID: I20240119001915 |
| Provider Name | Desiray Moore |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568865517 PECOS PAC ID: 1951753409 Enrollment ID: I20240119002308 |
| Provider Name | Brenda Gayle Chadwick-liechti |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588793780 PECOS PAC ID: 7618329046 Enrollment ID: I20240122000630 |
| Provider Name | Kim Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437582145 PECOS PAC ID: 4183076540 Enrollment ID: I20240122001781 |
| Provider Name | Krista Leigh Fincher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679621163 PECOS PAC ID: 1052763463 Enrollment ID: I20240122003507 |
| Provider Name | Lynnette Barnes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841552288 PECOS PAC ID: 1951753367 Enrollment ID: I20240122003539 |
| Provider Name | Courtney L. Akins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295940609 PECOS PAC ID: 4284086489 Enrollment ID: I20240123002604 |
| Provider Name | Stephanie Heffner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780929703 PECOS PAC ID: 2264884485 Enrollment ID: I20240123003088 |
| Provider Name | Deborah Dailey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417211251 PECOS PAC ID: 6608228838 Enrollment ID: I20240123003602 |
| Provider Name | Dorothea Shauna Humphreys |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861857229 PECOS PAC ID: 5597117739 Enrollment ID: I20240123004077 |
| Provider Name | Jessie Nicole Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447506324 PECOS PAC ID: 4981057171 Enrollment ID: I20240124000755 |
| Provider Name | Lisa Meredith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790999894 PECOS PAC ID: 9537512744 Enrollment ID: I20240124001365 |
| Provider Name | Marla Lynn Hill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154682177 PECOS PAC ID: 7416300629 Enrollment ID: I20240124001454 |
| Provider Name | Miranda F Summit |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396032066 PECOS PAC ID: 0648623868 Enrollment ID: I20240124001694 |
| Provider Name | Lisa Young |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275654196 PECOS PAC ID: 2062865298 Enrollment ID: I20240124002230 |
| Provider Name | Jami Cheri Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548461726 PECOS PAC ID: 7517310766 Enrollment ID: I20240124003002 |
| Provider Name | Nichole Rae Krausch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881200558 PECOS PAC ID: 1456704618 Enrollment ID: I20240124003259 |
| Provider Name | Kathy Lynn Davies |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578852208 PECOS PAC ID: 7214380484 Enrollment ID: I20240124003516 |
| Provider Name | Christina A Brogdon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134488000 PECOS PAC ID: 7012360282 Enrollment ID: I20240124003575 |
| Provider Name | Timothy Matthew Nida |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649599531 PECOS PAC ID: 3476906561 Enrollment ID: I20240124004681 |
| Provider Name | Patricia Leak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386048254 PECOS PAC ID: 1658724786 Enrollment ID: I20240125000832 |
| Provider Name | Crystal Needham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033480033 PECOS PAC ID: 2769835735 Enrollment ID: I20240125002601 |
| Provider Name | Valerie Ann Hinton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073946703 PECOS PAC ID: 4981057973 Enrollment ID: I20240125003275 |
| Provider Name | Tiffani Mccurtain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144612755 PECOS PAC ID: 0749633758 Enrollment ID: I20240125003918 |
| Provider Name | Taylor Shipp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437685922 PECOS PAC ID: 9133572175 Enrollment ID: I20240126000178 |
| Provider Name | Elizabeth Lanell Warren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063850170 PECOS PAC ID: 6103279724 Enrollment ID: I20240131001473 |
| Provider Name | Ronald Carroll Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902065337 PECOS PAC ID: 6002269446 Enrollment ID: I20240201000975 |
| Provider Name | Jeremiah M Daniel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316441652 PECOS PAC ID: 1052731155 Enrollment ID: I20240213003182 |
| Provider Name | Richard Nass |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1316018153 PECOS PAC ID: 8628256120 Enrollment ID: I20240217000179 |
| Provider Name | Carissa Kemp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982037479 PECOS PAC ID: 3072958883 Enrollment ID: I20240304000760 |
| Provider Name | Latoya Savon James |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730522988 PECOS PAC ID: 6608211305 Enrollment ID: I20240305000171 |
| Provider Name | Nedeljko Uncanin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346744737 PECOS PAC ID: 1052778123 Enrollment ID: I20240305003116 |
| Provider Name | Bryan Rowley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659715134 PECOS PAC ID: 6204272743 Enrollment ID: I20240307000368 |
| Provider Name | Jacob Eli Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184176091 PECOS PAC ID: 9133565427 Enrollment ID: I20240308001988 |
| Provider Name | Patricia Womack |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548709405 PECOS PAC ID: 7315383122 Enrollment ID: I20240314001455 |
| Provider Name | Loydena Beck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487866349 PECOS PAC ID: 7810334588 Enrollment ID: I20240318003187 |
| Provider Name | Eric Nash |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538124250 PECOS PAC ID: 3971583626 Enrollment ID: I20240320001124 |
| Provider Name | Michael Clay Brown |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386817468 PECOS PAC ID: 6002065083 Enrollment ID: I20240402001161 |
| Provider Name | Cornell Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700990421 PECOS PAC ID: 7719977503 Enrollment ID: I20240417000253 |
| Provider Name | Praveen Venigalla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528352598 PECOS PAC ID: 6103125232 Enrollment ID: I20240426000116 |
| Provider Name | Frank Dewayne Coolbroth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477768125 PECOS PAC ID: 1355781014 Enrollment ID: I20240429000111 |
| Provider Name | Casey Laws |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568406650 PECOS PAC ID: 0648221481 Enrollment ID: I20240502002808 |
| Provider Name | Cassandra Cummins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275769937 PECOS PAC ID: 6406207992 Enrollment ID: I20240506003532 |
| Provider Name | Jay Weingarten |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1801869177 PECOS PAC ID: 1759404783 Enrollment ID: I20240511000189 |
| Provider Name | Melissa Rainwater |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073557005 PECOS PAC ID: 8527023324 Enrollment ID: I20240514001769 |
| Provider Name | Marilyn Calderon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144486713 PECOS PAC ID: 1254465016 Enrollment ID: I20240516000632 |
| Provider Name | Jose Betancourt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1992748149 PECOS PAC ID: 8123043932 Enrollment ID: I20240605000548 |
Talihina Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Dallas St, Talihina, OK 74571 Phone: 918-567-7000 Fax: 918-567-7041 |