| Daniel Lee Nicoll, DO | |
|
601 E 13th St, Suite C, Grove, OK 74344-2989 | |
| (918) 786-7878 | |
| (918) 786-7884 |
| Full Name | Daniel Lee Nicoll |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 601 E 13th St, Grove, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487625505 | NPI | - | NPPES |
| 100185810C | Medicaid | OK | |
| 800522535 | Other | OK | MEDICARE GROUP PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3684 (Oklahoma) | Primary |
| 207VX0000X | Obstetrics & Gynecology - Obstetrics | 3684 (Oklahoma) | Secondary |
| Entity Name | Tulsa Emergency Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063479087 PECOS PAC ID: 3375442692 Enrollment ID: O20040106000606 |
| Entity Name | Medical Resource Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104056365 PECOS PAC ID: 4082753918 Enrollment ID: O20100830000840 |
| Entity Name | Urgent Care Of Grand Lake Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154022689 PECOS PAC ID: 1153796909 Enrollment ID: O20230407001178 |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel Lee Nicoll, DO 5300 N Independence Ave, Suite 280, Oklahoma City, OK 73112-5556 Ph: (918) 786-7878 | Daniel Lee Nicoll, DO 601 E 13th St, Suite C, Grove, OK 74344-2989 Ph: (918) 786-7878 |
Luke R Leming, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1001 E 18th St, Grove, OK 74344 Phone: 918-786-2243 Fax: 918-787-3403 | |
Renee Jean Russell, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1110 Neo Loop, Grove, OK 74344 Phone: 918-786-3100 Fax: 918-786-3108 | |
Dr. Phillip Scott Williams, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 601 E 13th St Ste H, Grove, OK 74344 Phone: 918-786-6228 Fax: 918-786-3724 | |
Dr. Kyle J Schauf, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 601 E 13th St, Suite G, Grove, OK 74344 Phone: 918-786-9009 Fax: 918-786-3724 | |
Jacob Hostetler, M.D. Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 4602 Us Highway 59, Grove, OK 74344 Phone: 918-877-1211 Fax: 918-877-1216 | |
Dr. Kioumars (none) Zarintash, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 900 E 13th St, 104, Grove, OK 74344 Phone: 918-786-3100 Fax: 918-786-3108 |