| Ihs Health Service | |
|
1515 Ne Lawrie Tatum Rd Lawton OK 73507-3002 | |
| (580) 354-5150 | |
| Not Available |
| Full Name | Ihs Health Service |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1515 Ne Lawrie Tatum Rd, Lawton, Oklahoma |
| Authorized Official Name and Position | Lenora Littledeer (CEO) |
| Authorized Official Contact | 5803545407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ihs Health Service 1515 Ne Lawrie Tatum Rd Lawton OK 73507-3002 Ph: (580) 354-5150 | Ihs Health Service 1515 Ne Lawrie Tatum Rd Lawton OK 73507-3002 Ph: (580) 354-5150 |
| NPI Number | 1760489223 |
|---|---|
| Provider Enumeration Date | 06/30/2005 |
| Last Update Date | 05/11/2020 |
| Medicare PECOS PAC ID | 6406800234 |
|---|---|
| Medicare Enrollment ID | O20050304000301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760489223 | NPI | - | NPPES |
| 100689220G | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | 21,818 (Oklahoma) | Primary |
| Provider Name | Olukayode O Okuwobi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245385657 PECOS PAC ID: 3375529639 Enrollment ID: I20040628000133 |
| Provider Name | Difu Guan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831190362 PECOS PAC ID: 0840251724 Enrollment ID: I20041023000273 |
| Provider Name | Vijay Adusumilli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487615647 PECOS PAC ID: 3375524754 Enrollment ID: I20050323000530 |
| Provider Name | Carla J Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487691234 PECOS PAC ID: 3870546047 Enrollment ID: I20050324001048 |
| Provider Name | Charles Dryden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255371522 PECOS PAC ID: 3375599988 Enrollment ID: I20050328000302 |
| Provider Name | Christie L Coggburn |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1861610503 PECOS PAC ID: 3678514338 Enrollment ID: I20050512000904 |
| Provider Name | Timothy T Mccay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245221761 PECOS PAC ID: 2961456538 Enrollment ID: I20050621000935 |
| 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 | Robert Moss |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548232432 PECOS PAC ID: 9436187135 Enrollment ID: I20050803000423 |
| Provider Name | Jeffrey L Russell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1942309034 PECOS PAC ID: 5294769568 Enrollment ID: I20050926000755 |
| Provider Name | John D Walton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326096850 PECOS PAC ID: 3375546054 Enrollment ID: I20060907000113 |
| Provider Name | Jasmine R Gaddy |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1881628758 PECOS PAC ID: 7416953336 Enrollment ID: I20061016000421 |
| Provider Name | Myeong S Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497722342 PECOS PAC ID: 0042227266 Enrollment ID: I20070219000272 |
| Provider Name | Carrie E De Moor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922292754 PECOS PAC ID: 8325128853 Enrollment ID: I20080109000392 |
| Provider Name | Arun D Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164452082 PECOS PAC ID: 6406926682 Enrollment ID: I20080530000075 |
| Provider Name | Stacy Chemda Goode |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225248784 PECOS PAC ID: 1052497591 Enrollment ID: I20080916000415 |
| Provider Name | Laura L Arrowsmith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083654800 PECOS PAC ID: 9638123631 Enrollment ID: I20081014000674 |
| Provider Name | Judith Wolfstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013914456 PECOS PAC ID: 0345135232 Enrollment ID: I20081203000298 |
| 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 | Lora A Williams |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1982859625 PECOS PAC ID: 9739231077 Enrollment ID: I20090716000496 |
| 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 | Barbara M Heying |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750459954 PECOS PAC ID: 1658441787 Enrollment ID: I20090928000478 |
| Provider Name | Linda R Boyd |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497712780 PECOS PAC ID: 9133283039 Enrollment ID: I20091008000525 |
| Provider Name | Natasha Nicole Harrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770756173 PECOS PAC ID: 2365580461 Enrollment ID: I20091110000622 |
| Provider Name | Elsa L Marshall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932219342 PECOS PAC ID: 1153491469 Enrollment ID: I20091119000568 |
| Provider Name | Hari S Kapur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750370482 PECOS PAC ID: 7517000540 Enrollment ID: I20100129000658 |
| Provider Name | Scott M Malowney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649269507 PECOS PAC ID: 0941336945 Enrollment ID: I20100330000019 |
| Provider Name | Michelle M Ponder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447399415 PECOS PAC ID: 4880787217 Enrollment ID: I20100428000166 |
| Provider Name | Christos Vassiliou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053567784 PECOS PAC ID: 8820120454 Enrollment ID: I20100719000117 |
| Provider Name | Maribel Colon-santiago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942312103 PECOS PAC ID: 9133253289 Enrollment ID: I20100811000985 |
| Provider Name | Cecilio R Ramirez Rossy |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972671964 PECOS PAC ID: 4688799026 Enrollment ID: I20100909000163 |
| Provider Name | Steven P Sanders |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023094620 PECOS PAC ID: 3274722434 Enrollment ID: I20110104001128 |
| Provider Name | Amy Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962577023 PECOS PAC ID: 2567651789 Enrollment ID: I20110114000419 |
| Provider Name | Michelle Bruce Nobles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992777007 PECOS PAC ID: 1153343363 Enrollment ID: I20110126000135 |
| Provider Name | Mohamed K Awad |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1245414036 PECOS PAC ID: 7012198187 Enrollment ID: I20110222001062 |
| Provider Name | Nina C Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003877754 PECOS PAC ID: 6901833367 Enrollment ID: I20110414000371 |
| Provider Name | Luis E Millan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497068183 PECOS PAC ID: 2264619949 Enrollment ID: I20110606000594 |
| Provider Name | Michael L Gearhart |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427214022 PECOS PAC ID: 7113080086 Enrollment ID: I20110823001046 |
| Provider Name | Deqing Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811048622 PECOS PAC ID: 4486849049 Enrollment ID: I20110829000494 |
| Provider Name | Stephen A Back |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639302060 PECOS PAC ID: 3476723594 Enrollment ID: I20110829000547 |
| Provider Name | Andrew J Dominguez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447547799 PECOS PAC ID: 8325219702 Enrollment ID: I20110914000771 |
| Provider Name | Chad A Stuckey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134282189 PECOS PAC ID: 5092716852 Enrollment ID: I20110922000625 |
| Provider Name | James R Cantu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780977512 PECOS PAC ID: 6507037280 Enrollment ID: I20110929000508 |
| Provider Name | Carol Ann Browning |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780864033 PECOS PAC ID: 4385705888 Enrollment ID: I20120123000164 |
| Provider Name | Beatrice Christopher |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073542189 PECOS PAC ID: 6800883265 Enrollment ID: I20120222001025 |
| Provider Name | Vinay A Shah |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1013951409 PECOS PAC ID: 2567513492 Enrollment ID: I20120313000984 |
| Provider Name | Gregory D Clift |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255362646 PECOS PAC ID: 7315106119 Enrollment ID: I20120314000717 |
| Provider Name | Mark E Rathgeber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114090248 PECOS PAC ID: 4789878422 Enrollment ID: I20120417000672 |
| Provider Name | Steven L Fillmore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225010655 PECOS PAC ID: 2668403080 Enrollment ID: I20120615000567 |
| Provider Name | Laura L Alexander |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356601728 PECOS PAC ID: 5193980605 Enrollment ID: I20120709000416 |
| 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 | Jeffrey W Shelton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194864074 PECOS PAC ID: 7719141639 Enrollment ID: I20120823000396 |
| Provider Name | Lynda-marie S George |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962471847 PECOS PAC ID: 5890730063 Enrollment ID: I20120924000435 |
| Provider Name | Jean Hausheer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1861490930 PECOS PAC ID: 0446205637 Enrollment ID: I20121025000162 |
| Provider Name | Carmen M Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558613158 PECOS PAC ID: 8123272572 Enrollment ID: I20130212000179 |
| Provider Name | Robert J Hitchcock |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952343139 PECOS PAC ID: 4789665761 Enrollment ID: I20130619000275 |
| Provider Name | Jonathon D Kirkland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639315260 PECOS PAC ID: 4789823139 Enrollment ID: I20130726000027 |
| Provider Name | James N Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306089578 PECOS PAC ID: 4284876558 Enrollment ID: I20130911000061 |
| Provider Name | Kanwardeep Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477713378 PECOS PAC ID: 1658542808 Enrollment ID: I20140130001965 |
| 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 | Tyler T Bay |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1083816490 PECOS PAC ID: 3971699794 Enrollment ID: I20140725001132 |
| 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 | Julide D Akman-carmichael |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518287713 PECOS PAC ID: 7113165242 Enrollment ID: I20140917001360 |
| Provider Name | Bo Yon Choi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053551721 PECOS PAC ID: 5890920870 Enrollment ID: I20140925002205 |
| Provider Name | Andrea Hicks |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457585499 PECOS PAC ID: 4385864057 Enrollment ID: I20140930002679 |
| Provider Name | Logan Harding |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407171952 PECOS PAC ID: 1759576838 Enrollment ID: I20141001002690 |
| Provider Name | Paul G Pierce |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952499337 PECOS PAC ID: 5092964577 Enrollment ID: I20141113000881 |
| Provider Name | Deborah J Moreau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164754008 PECOS PAC ID: 4981733482 Enrollment ID: I20141205001672 |
| Provider Name | Emad Shoukry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053318857 PECOS PAC ID: 1759353337 Enrollment ID: I20141231001191 |
| Provider Name | David J Ingle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700884491 PECOS PAC ID: 4688561368 Enrollment ID: I20150116001899 |
| 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 | Marcus Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275776965 PECOS PAC ID: 8224250816 Enrollment ID: I20150910000185 |
| Provider Name | Stella S Vinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780832741 PECOS PAC ID: 7911074141 Enrollment ID: I20151116001232 |
| Provider Name | Moaz W Abulfaraj |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861797193 PECOS PAC ID: 3577797349 Enrollment ID: I20151202001868 |
| Provider Name | Amy Crowder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831164342 PECOS PAC ID: 3072590249 Enrollment ID: I20160108000090 |
| Provider Name | Julianna Lindsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225079361 PECOS PAC ID: 6507895414 Enrollment ID: I20160223001333 |
| Provider Name | Brian E Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407810963 PECOS PAC ID: 6406936970 Enrollment ID: I20160223001453 |
| Provider Name | Mary Pat Hamilton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861439002 PECOS PAC ID: 8527961135 Enrollment ID: I20160517000877 |
| Provider Name | Jose Maria Borrego Acosta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598807216 PECOS PAC ID: 0143384784 Enrollment ID: I20160601002554 |
| Provider Name | Michelle R Schenk |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306018734 PECOS PAC ID: 9537334594 Enrollment ID: I20160629000852 |
| Provider Name | George Polanco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326019332 PECOS PAC ID: 0244210755 Enrollment ID: I20160713002114 |
| Provider Name | John D Fitz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124011317 PECOS PAC ID: 9133278799 Enrollment ID: I20160804001299 |
| Provider Name | Mark M Jackson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144391525 PECOS PAC ID: 0749321776 Enrollment ID: I20161019001850 |
| Provider Name | John Warrick |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1932185030 PECOS PAC ID: 2860518784 Enrollment ID: I20161022000000 |
| Provider Name | Ronald A Stillerman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679549166 PECOS PAC ID: 7214958370 Enrollment ID: I20161122000168 |
| Provider Name | Renee Roy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649200361 PECOS PAC ID: 2860446259 Enrollment ID: I20161215000415 |
| Provider Name | Oladipo Igbekoyi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164869509 PECOS PAC ID: 1254631880 Enrollment ID: I20170123002008 |
| Provider Name | Bart M Rowlett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104945526 PECOS PAC ID: 5092602102 Enrollment ID: I20170215002368 |
| Provider Name | Mary A Mcafee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417905928 PECOS PAC ID: 9931483070 Enrollment ID: I20170309000041 |
| Provider Name | Emad Hamid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457553588 PECOS PAC ID: 7618021999 Enrollment ID: I20170502001404 |
| Provider Name | Kenneth E Mann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851398713 PECOS PAC ID: 7113985441 Enrollment ID: I20170519000382 |
| Provider Name | Joshua R Telfer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447709563 PECOS PAC ID: 7113205170 Enrollment ID: I20170522000214 |
| Provider Name | Adam Boice Foster |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811230311 PECOS PAC ID: 6406123504 Enrollment ID: I20170526000322 |
| Provider Name | Kathryn Newport |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194717769 PECOS PAC ID: 5395822985 Enrollment ID: I20170607000892 |
| Provider Name | Amy Casey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053717546 PECOS PAC ID: 3678885738 Enrollment ID: I20170629001362 |
| Provider Name | Blake Edward Weaver |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497785893 PECOS PAC ID: 6103890975 Enrollment ID: I20170629001468 |
| Provider Name | Kathy Woodward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568845899 PECOS PAC ID: 5395050439 Enrollment ID: I20170705000637 |
| Provider Name | Kimberly Irene Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942737374 PECOS PAC ID: 3678532439 Enrollment ID: I20170717000198 |
| Provider Name | Laurette Rivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205254752 PECOS PAC ID: 9638441819 Enrollment ID: I20170823001303 |
| Provider Name | Brad Victor Nuttall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699290478 PECOS PAC ID: 7810261690 Enrollment ID: I20170918000843 |
| Provider Name | Matthew Wood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972918720 PECOS PAC ID: 4880995182 Enrollment ID: I20170918001846 |
| Provider Name | Kevin L Hamm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578657623 PECOS PAC ID: 8022919620 Enrollment ID: I20171014000017 |
| Provider Name | Shantel T Blume |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073045282 PECOS PAC ID: 5597021014 Enrollment ID: I20171115002884 |
| Provider Name | Sheila D Henderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174576565 PECOS PAC ID: 1850366006 Enrollment ID: I20171128002654 |
| Provider Name | Ali Saleem |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639448020 PECOS PAC ID: 1759501562 Enrollment ID: I20171207001100 |
| Provider Name | Marc W Levin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235131749 PECOS PAC ID: 1951291293 Enrollment ID: I20171219002534 |
| Provider Name | Craig White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417278573 PECOS PAC ID: 2365757481 Enrollment ID: I20180104000432 |
| Provider Name | Terica Webber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265944110 PECOS PAC ID: 1052670247 Enrollment ID: I20180116001121 |
| Provider Name | Carolina Vanessa Solis Sanabria |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548404874 PECOS PAC ID: 3072872159 Enrollment ID: I20180117003013 |
| Provider Name | Eric E Arbuckle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114372901 PECOS PAC ID: 3274892104 Enrollment ID: I20180122001512 |
| Provider Name | Alisha R Miner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053761551 PECOS PAC ID: 3375801426 Enrollment ID: I20180215000673 |
| Provider Name | Nena Ann Stanley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598908006 PECOS PAC ID: 8022253657 Enrollment ID: I20180216000402 |
| Provider Name | Eric Sparks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215387717 PECOS PAC ID: 0244598977 Enrollment ID: I20180416000570 |
| Provider Name | Melissa D Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932564432 PECOS PAC ID: 2961707914 Enrollment ID: I20180426002083 |
| Provider Name | Natalia Solomon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003173915 PECOS PAC ID: 6709141328 Enrollment ID: I20180601001555 |
| Provider Name | Jessica Funk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912376740 PECOS PAC ID: 2062767205 Enrollment ID: I20180612002337 |
| Provider Name | Samuel B Hancock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063672608 PECOS PAC ID: 3577699073 Enrollment ID: I20180614000232 |
| Provider Name | Julia D Knarreborg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952662363 PECOS PAC ID: 3173828803 Enrollment ID: I20180703001304 |
| Provider Name | Tara E Van Drunen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598787442 PECOS PAC ID: 1557685757 Enrollment ID: I20180713000476 |
| Provider Name | Jessica Meador |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952751455 PECOS PAC ID: 5597012310 Enrollment ID: I20180724003254 |
| 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 | 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 | Steven Matthew Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366733404 PECOS PAC ID: 0042536575 Enrollment ID: I20180912003056 |
| Provider Name | Jeff Salsieder |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508240300 PECOS PAC ID: 2860743424 Enrollment ID: I20180920000380 |
| Provider Name | Kyle F Summers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346663135 PECOS PAC ID: 6406119593 Enrollment ID: I20180926000466 |
| 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 | Yolette Louis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225316318 PECOS PAC ID: 6204070790 Enrollment ID: I20181029001785 |
| Provider Name | Shawn D Grant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043214497 PECOS PAC ID: 6204877079 Enrollment ID: I20181211000646 |
| Provider Name | Sopukro W Tienabeso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770513442 PECOS PAC ID: 3971533217 Enrollment ID: I20181214002014 |
| Provider Name | Paul D Kivela |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669410247 PECOS PAC ID: 8022108414 Enrollment ID: I20181228000576 |
| Provider Name | Briant Thanh Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497191910 PECOS PAC ID: 6507135191 Enrollment ID: I20190114001225 |
| Provider Name | Angela Battese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023487311 PECOS PAC ID: 8921347626 Enrollment ID: I20190225000805 |
| Provider Name | Janet Ilidan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831599539 PECOS PAC ID: 4587903976 Enrollment ID: I20190301000956 |
| Provider Name | Joel Garrett Massey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396805966 PECOS PAC ID: 7618115130 Enrollment ID: I20190329000883 |
| Provider Name | Eric Timothy Hogan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144343435 PECOS PAC ID: 5193894301 Enrollment ID: I20190408000415 |
| Provider Name | Mohammad Azeem Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285920173 PECOS PAC ID: 0446476865 Enrollment ID: I20190529000876 |
| Provider Name | Jentry K Mclaughlin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780110221 PECOS PAC ID: 9739421041 Enrollment ID: I20190606000094 |
| Provider Name | Natalie Grisham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134567548 PECOS PAC ID: 6800190844 Enrollment ID: I20190611003583 |
| 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 | Michelle Lynn Deason |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376786103 PECOS PAC ID: 7719212992 Enrollment ID: I20190710001653 |
| Provider Name | Patti A Hacker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114368669 PECOS PAC ID: 7416284062 Enrollment ID: I20190806001131 |
| Provider Name | Randy W Cox |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467939249 PECOS PAC ID: 1153659164 Enrollment ID: I20190828001611 |
| 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 | James Connor Sullivan |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1518524404 PECOS PAC ID: 4981935970 Enrollment ID: I20191004001868 |
| Provider Name | Jane Walta |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477881712 PECOS PAC ID: 1951632462 Enrollment ID: I20191015002038 |
| Provider Name | Nicholas A Strle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851703185 PECOS PAC ID: 4587999354 Enrollment ID: I20191115001941 |
| Provider Name | Cameron P Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831515287 PECOS PAC ID: 7214264449 Enrollment ID: I20191116000000 |
| Provider Name | Sheryll D Elder |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1235107442 PECOS PAC ID: 0941290639 Enrollment ID: I20200106000378 |
| Provider Name | Ming T Lin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427088947 PECOS PAC ID: 9133186125 Enrollment ID: I20200124000272 |
| Provider Name | Jeff Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073933289 PECOS PAC ID: 2567899552 Enrollment ID: I20200304001706 |
| Provider Name | Brian Samuel Oliver |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548288806 PECOS PAC ID: 2062431877 Enrollment ID: I20200406000667 |
| Provider Name | Sarah Charity Pursley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942735576 PECOS PAC ID: 5193095065 Enrollment ID: I20200407003858 |
| Provider Name | Christopher Livingstone Gibert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033141775 PECOS PAC ID: 2264335645 Enrollment ID: I20200415000536 |
| Provider Name | Nathan Blacker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407358922 PECOS PAC ID: 1355771999 Enrollment ID: I20200421003203 |
| 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 | Mason Hunt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144546821 PECOS PAC ID: 7012140858 Enrollment ID: I20200701000173 |
| Provider Name | Christopher D Roman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033266838 PECOS PAC ID: 1850482761 Enrollment ID: I20200701000532 |
| Provider Name | Gregory Michael Pfitzer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396199147 PECOS PAC ID: 2860722204 Enrollment ID: I20200717000109 |
| Provider Name | Kevin Nathaniel Blythe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902149123 PECOS PAC ID: 5193013928 Enrollment ID: I20200729000931 |
| Provider Name | Taylor Rae Erhardt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831713957 PECOS PAC ID: 6305263518 Enrollment ID: I20200902003080 |
| Provider Name | Vikram S Shankar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821443276 PECOS PAC ID: 5294154894 Enrollment ID: I20201001000468 |
| Provider Name | Crystal B Kronenberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558690719 PECOS PAC ID: 8527346758 Enrollment ID: I20201002001987 |
| Provider Name | Tamara Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316372527 PECOS PAC ID: 9830325828 Enrollment ID: I20201112001667 |
| Provider Name | John D Harrington |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992729156 PECOS PAC ID: 0244276251 Enrollment ID: I20201202000357 |
| Provider Name | Matthew Sims |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982167813 PECOS PAC ID: 6204250376 Enrollment ID: I20201203001738 |
| Provider Name | Dimple Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306023809 PECOS PAC ID: 5991952178 Enrollment ID: I20210114000460 |
| Provider Name | Nancy Davison |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689105314 PECOS PAC ID: 7113290495 Enrollment ID: I20210125000540 |
| Provider Name | Birdena Denise Aguilera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063904662 PECOS PAC ID: 0244645042 Enrollment ID: I20210208002381 |
| Provider Name | Chelsey Morgan Beathard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124683578 PECOS PAC ID: 0446650287 Enrollment ID: I20210615002814 |
| Provider Name | Lee Easterwood |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366503534 PECOS PAC ID: 3779533393 Enrollment ID: I20210625000610 |
| 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 | Mu En Hu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467915256 PECOS PAC ID: 6800299579 Enrollment ID: I20210720000644 |
| Provider Name | Eric Mathis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699238105 PECOS PAC ID: 0648673293 Enrollment ID: I20210720003967 |
| Provider Name | Taylor Heck |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710418041 PECOS PAC ID: 5193128767 Enrollment ID: I20210721000639 |
| Provider Name | Anita W Eisenhart |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649237678 PECOS PAC ID: 0244121127 Enrollment ID: I20210723000060 |
| Provider Name | Dimitri A Yanez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568537025 PECOS PAC ID: 6002966843 Enrollment ID: I20210727001313 |
| Provider Name | David M Baulesh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063899078 PECOS PAC ID: 9830485481 Enrollment ID: I20210813002568 |
| Provider Name | Philip Pookkattu Paul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821524364 PECOS PAC ID: 1951678499 Enrollment ID: I20210826002896 |
| Provider Name | Megan Philkhana |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316441702 PECOS PAC ID: 3173929429 Enrollment ID: I20210910002921 |
| Provider Name | Hyemin April Kim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700415403 PECOS PAC ID: 1951705623 Enrollment ID: I20211122003052 |
| Provider Name | Soumya Vempalle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134514896 PECOS PAC ID: 9032500392 Enrollment ID: I20211220002762 |
| Provider Name | Samina Zafar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659853851 PECOS PAC ID: 3274887401 Enrollment ID: I20211222000717 |
| Provider Name | Laura E Marble |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386604361 PECOS PAC ID: 2860570553 Enrollment ID: I20211228001411 |
| Provider Name | Amaya Basta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457589699 PECOS PAC ID: 0042434524 Enrollment ID: I20220118001954 |
| Provider Name | Shawn Franklin Gasaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215561642 PECOS PAC ID: 9335119197 Enrollment ID: I20220209000709 |
| Provider Name | Jeffrey Lebowitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891747002 PECOS PAC ID: 9638065048 Enrollment ID: I20220301000756 |
| Provider Name | Dustin W Cheney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225492606 PECOS PAC ID: 9133523418 Enrollment ID: I20220324000946 |
| Provider Name | Brittany Ann Claudean Jane Napoleon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740842863 PECOS PAC ID: 4880027689 Enrollment ID: I20220426002741 |
| Provider Name | Kyle Tanner Barfield |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255835476 PECOS PAC ID: 6507101011 Enrollment ID: I20220525002078 |
| 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 | Christopher Leiker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447755863 PECOS PAC ID: 2264782531 Enrollment ID: I20220713000798 |
| Provider Name | Michael D Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215956768 PECOS PAC ID: 3971674862 Enrollment ID: I20220805001710 |
| Provider Name | Mustapha Daouadi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598906802 PECOS PAC ID: 4789993395 Enrollment ID: I20220913003698 |
| Provider Name | Gregory Bradley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881135804 PECOS PAC ID: 6608207824 Enrollment ID: I20221013000072 |
| Provider Name | Christie Arnold Leal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992044044 PECOS PAC ID: 9537484969 Enrollment ID: I20221025001910 |
| Provider Name | Paul Stephen Strait |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821054651 PECOS PAC ID: 4284994328 Enrollment ID: I20221108000323 |
| Provider Name | Oliver Cvitanic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538267208 PECOS PAC ID: 2567490204 Enrollment ID: I20221205003181 |
| Provider Name | Joseph Eble |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972766806 PECOS PAC ID: 9436205952 Enrollment ID: I20230102000149 |
| Provider Name | Augustine Y Alifo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114926375 PECOS PAC ID: 8729077151 Enrollment ID: I20230309001047 |
| Provider Name | David J Adinaro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114039849 PECOS PAC ID: 5991753675 Enrollment ID: I20230309001905 |
| Provider Name | Yoldez A Meroueh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578096723 PECOS PAC ID: 7315298569 Enrollment ID: I20230314000287 |
| Provider Name | Islam Fayed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316300320 PECOS PAC ID: 3072922806 Enrollment ID: I20230403000723 |
| Provider Name | Michael Edward Sabatino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447425673 PECOS PAC ID: 1951571736 Enrollment ID: I20230526000985 |
| Provider Name | Kathleen L Shaffer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912940834 PECOS PAC ID: 7012011265 Enrollment ID: I20230530002881 |
| Provider Name | Aman Mittal |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699126425 PECOS PAC ID: 9931521093 Enrollment ID: I20230530003341 |
| Provider Name | Azka Arif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417478371 PECOS PAC ID: 1850758574 Enrollment ID: I20230612000150 |
| Provider Name | Austin Marsh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346773850 PECOS PAC ID: 7911389002 Enrollment ID: I20230624000094 |
| Provider Name | Mehyar Hefazi Torghabeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548655343 PECOS PAC ID: 9830586767 Enrollment ID: I20230701000263 |
| Provider Name | Samantha K De Luca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710541859 PECOS PAC ID: 7416318027 Enrollment ID: I20230731000147 |
| Provider Name | Linda G Clark |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659390029 PECOS PAC ID: 6002908167 Enrollment ID: I20230816000020 |
| Provider Name | Aubrey J Slaughter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851596936 PECOS PAC ID: 4486898145 Enrollment ID: I20230913000750 |
| 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 | Alex Funicello |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992906432 PECOS PAC ID: 3072600014 Enrollment ID: I20240112003867 |
| Provider Name | Jeremiah M Daniel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316441652 PECOS PAC ID: 1052731155 Enrollment ID: I20240213003182 |
| Provider Name | Nedeljko Uncanin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346744737 PECOS PAC ID: 1052778123 Enrollment ID: I20240305003116 |
| Provider Name | Daniel J Resop |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417938358 PECOS PAC ID: 0244292019 Enrollment ID: I20240322000262 |
| Provider Name | Melanie D Hazle |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851702401 PECOS PAC ID: 3779920087 Enrollment ID: I20240322000282 |
| Provider Name | David A Duncan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427041656 PECOS PAC ID: 5991837262 Enrollment ID: I20240427001805 |
| Provider Name | Kenneth L Holbert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093762148 PECOS PAC ID: 2466408497 Enrollment ID: I20240521002061 |
| Provider Name | Michelle A Matthey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912002627 PECOS PAC ID: 9931374725 Enrollment ID: I20240522002271 |
| Provider Name | Kurt F Jaenicke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073671673 PECOS PAC ID: 2264526276 Enrollment ID: I20240603003994 |
| Provider Name | Sunnia Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609480813 PECOS PAC ID: 0244625952 Enrollment ID: I20240603004045 |
Laura Coleman, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5366 Nw Cache Rd, Suite 6, Lawton, OK 73505 Phone: 580-536-7546 Fax: 580-581-2051 | |
Mark W Cotton Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5610 Sw Lee Blvd, Lawton, OK 73505 Phone: 580-536-6600 Fax: 580-536-2427 | |
Legacy Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 927 Sw D Ave, Lawton, OK 73501 Phone: 405-936-0504 Fax: 405-936-0561 | |
Memorial Medical Group Minor Emergency Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4411 W Gore Blvd, Suite A2, Lawton, OK 73505 Phone: 580-355-0575 Fax: 580-248-1725 | |
Bobby Abraham Md Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3201 W Gore Blvd, Suite 105, Lawton, OK 73505 Phone: 580-510-7077 Fax: 580-510-7057 | |
R. Brent Smith, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4411 W Gore Blvd, Ste. B-5, Lawton, OK 73505 Phone: 580-357-0493 | |
Sooner Inpatient Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3401 W Gore Blvd, Lawton, OK 73505 Phone: 954-838-2371 |