| Charles Dewayne Black, DO | |
|
1011 14th Ave Nw, Er Dept., Ardmore, OK 73401-1828 | |
| (580) 220-6415 | |
| (405) 749-4561 |
| Full Name | Charles Dewayne Black |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 34 Years |
| Location | 1011 14th Ave Nw, Ardmore, 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 |
|---|---|---|---|
| 1891757860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 3023 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Integris Marshall County Medical Center | Madill, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Elite Integral Staffing Llc | 0648612341 | 11 |
| Entity Name | Nes Oklahoma, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528040722 PECOS PAC ID: 1456264324 Enrollment ID: O20040726000516 |
| Entity Name | Oklahoma Emergency Physician Partners Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891039764 PECOS PAC ID: 0345493649 Enrollment ID: O20130118000115 |
| Entity Name | Elite Integral Staffing Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609648062 PECOS PAC ID: 0648612341 Enrollment ID: O20240528000354 |
| Entity Name | Exceptional Physicians Group Ardmore Hospital Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588427462 PECOS PAC ID: 8921542622 Enrollment ID: O20240705002168 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Dewayne Black, DO 4401 W Memorial Rd, Suite 121, Oklahoma City, OK 73134-1785 Ph: (405) 751-4664 | Charles Dewayne Black, DO 1011 14th Ave Nw, Er Dept., Ardmore, OK 73401-1828 Ph: (580) 220-6415 |
Jeffery Thomas Ross, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1011 14th Ave Nw, Ardmore, OK 73401 Phone: 580-220-6132 Fax: 580-220-6772 | |
Mark Damon Ii, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1011 14th Ave Nw, Ardmore, OK 73401 Phone: 580-220-6658 Fax: 580-220-6673 | |
Ernest Byron Foster Ii, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1011 14th Ave Nw, Ardmore, OK 73401 Phone: 580-220-6658 Fax: 580-220-6673 | |
Dr. Daniel Ryan Wheeler, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1011 14th Ave Nw, Ardmore, OK 73401 Phone: 580-220-6588 | |
Lindsay Anne Wilson, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1011 14th Ave Nw, Ardmore, OK 73401 Phone: 580-220-6132 Fax: 580-220-6772 | |
Daniel Francis Mckinley, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1011 14th Ave Nw, Ardmore, OK 73401 Phone: 580-220-6658 Fax: 580-220-6673 | |
Dr. Jason Andrew Carter, MD, MHSA, FACEP Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 4th Ave Nw Ste 96, Ardmore, OK 73401 Phone: 417-612-3985 |