| Dr Chad D Willis, DO | |
|
3214 Kethley Rd, Shawnee, OK 74804-9625 | |
| (405) 273-5801 | |
| (405) 878-3794 |
| Full Name | Dr Chad D Willis |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 20 Years |
| Location | 3214 Kethley Rd, Shawnee, 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 |
|---|---|---|---|
| 1750432043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 2006033639 (Missouri) | Secondary |
| 207YX0007X | Otolaryngology - Plastic Surgery Within The Head & Neck | 4875 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm Health St Anthony Hospital - Shawnee | Shawnee, OK | Hospital |
| Ssm Health St Anthony Hospital - Oklahoma City | Oklahoma city, OK | Hospital |
| O U Medical Center | Oklahoma city, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saints Medical Group, Llc | 7012914898 | 395 |
| Entity Name | Shawnee Medical Center Clinic, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881648285 PECOS PAC ID: 3870405434 Enrollment ID: O20031103000239 |
| Entity Name | Purcell Municipal Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467476911 PECOS PAC ID: 7719899400 Enrollment ID: O20031106000100 |
| Entity Name | Saints Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437195922 PECOS PAC ID: 7012914898 Enrollment ID: O20061109000189 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Chad D Willis, DO Po Box 258884, Oklahoma City, OK 73125-8884 Ph: (405) 231-3857 | Dr Chad D Willis, DO 3214 Kethley Rd, Shawnee, OK 74804-9625 Ph: (405) 273-5801 |
Dr. Craig X Summers, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 1102 W Macarthur St, Shawnee, OK 74804 Phone: 405-878-8183 Fax: 405-878-8101 |