| Benjamin Holler, | |
|
12142 S Yukon Avenue, Glenpool, OK 74033-6621 | |
| (918) 935-3636 | |
| (918) 777-9019 |
| Full Name | Benjamin Holler |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 9 Years |
| Location | 12142 S Yukon Avenue, Glenpool, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902335698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 52911 (Kentucky) | Secondary |
| 207P00000X | Emergency Medicine | R4433 (Kentucky) | Secondary |
| 207Q00000X | Family Medicine | 38874 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Jackson County Regional Health Center | Maquoketa, IA | Hospital |
| Byrd Regional Hospital | Leesville, LA | Hospital |
| Opelousas General Health System | Opelousas, LA | Hospital |
| Lake Charles Memorial Hospital | Lake charles, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kisatchie Emergency Group Llc | 9537400270 | 19 |
| Northern Louisiana Emergency Physicians, Llp | 9638246846 | 31 |
| Transformation Health Pllc | 3476895822 | 2 |
| Entity Name | Northern Louisiana Emergency Physicians, Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588828172 PECOS PAC ID: 9638246846 Enrollment ID: O20080930000036 |
| Entity Name | Riverside Emergency Physician Partners Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083107080 PECOS PAC ID: 0042568917 Enrollment ID: O20180809000406 |
| Entity Name | Kisatchie Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235693847 PECOS PAC ID: 9537400270 Enrollment ID: O20190408001290 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Holler, 12142 S Yukon Avenue, Glenpool, OK 74033-6621 Ph: (918) 935-3636 | Benjamin Holler, 12142 S Yukon Avenue, Glenpool, OK 74033-6621 Ph: (918) 935-3636 |
Dr. Alexander C Roby, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 140 W 151st St S Ste 202, Glenpool, OK 74033 Phone: 918-321-7400 Fax: 918-321-7415 | |
Sharon K Little, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 140 W 151st St S Ste 202, Glenpool, OK 74033 Phone: 918-321-7400 Fax: 918-321-7415 | |
Dr. Tony A Little, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 140 W 151st St S Ste 202, Glenpool, OK 74033 Phone: 918-321-7400 Fax: 918-321-7415 | |
Emily White, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 140 W 151st St S Ste 202, Glenpool, OK 74033 Phone: 918-321-7400 Fax: 918-321-7415 | |
Dr. Daniel Craig Martin, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 14226 Elm, Glenpool, OK 74033 Phone: 918-322-9510 | |
Dr. Michael Steven Ward, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 550 W 121st St S, Glenpool, OK 74033 Phone: 918-291-5200 Fax: 918-291-5929 | |
Dr. Andrea Michele Adams, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 550 W 121st St S, Glenpool, OK 74033 Phone: 918-291-5200 Fax: 918-291-5929 |