| Jesse Craighead, | |
|
747 Highway 59 # 4, Westville, OK 74965-1508 | |
| (918) 723-3757 | |
| Not Available |
| Full Name | Jesse Craighead |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 747 Highway 59 # 4, Westville, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558722652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 200534020A (Oklahoma) | Primary |
| Entity Name | Cherokee Nation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780692723 PECOS PAC ID: 5799698742 Enrollment ID: O20031106000628 |
| Mailing Address | Practice Location Address |
|---|---|
| Jesse Craighead, 747 Highway 59 # 4, Westville, OK 74965-1508 Ph: () - | Jesse Craighead, 747 Highway 59 # 4, Westville, OK 74965-1508 Ph: (918) 723-3757 |
Amy Rusk, Counselor Medicare: Not Enrolled in Medicare Practice Location: 747 Hwy 59 #4, Westville, OK 74965 Phone: 918-723-3735 Fax: 918-723-3730 | |
Jennie Pruitt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 747 Highway 59 Ste 4, Westville, OK 74965 Phone: 479-220-9857 | |
Charles Cornelius Pastoor, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 747 Highway 59, Westville, OK 74965 Phone: 918-723-3735 |