| Dr Chukwukadibia J Odunukwe, MD | |
|
5604 Sw Lee Blvd, Suite 210, Lawton, OK 73505-9681 | |
| (580) 531-6462 | |
| (580) 531-6426 |
| Full Name | Dr Chukwukadibia J Odunukwe |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 5604 Sw Lee Blvd, Lawton, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992778831 | NPI | - | NPPES |
| 1123714 | Medicaid | OK | |
| P00769476 | Other | OK | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 23714 (Oklahoma) | Primary |
| Entity Name | Southwestern Surgical Affiliates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013169531 PECOS PAC ID: 0941365308 Enrollment ID: O20090218000457 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Chukwukadibia J Odunukwe, MD Po Box 8679, Belfast, ME 04915-8679 Ph: (580) 531-6465 | Dr Chukwukadibia J Odunukwe, MD 5604 Sw Lee Blvd, Suite 210, Lawton, OK 73505-9681 Ph: (580) 531-6462 |
Peng Yu, MD, PHD Surgery Medicare: Medicare Enrolled Practice Location: 5604 Sw Lee Blvd Ste 210, Lawton, OK 73505 Phone: 580-531-6465 Fax: 580-531-6426 | |
Natalie Banks Grisham, MD Surgery Medicare: Medicare Enrolled Practice Location: 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507 Phone: 580-354-5000 | |
Daniel Max Goates, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 110 Nw 31st St, Lawton, OK 73505 Phone: 508-510-7042 | |
Dr. Jaime Buenaventura Pilar, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507 Phone: 580-353-0350 | |
Dr. John Nereus Carter, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 110 Nw 31st St, 3rd Floor, Lawton, OK 73505 Phone: 580-510-7042 Fax: 580-510-7044 | |
Elissa J Hunter, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 110 Nw 31st St, 3rd Floor, Lawton, OK 73505 Phone: 580-510-7042 Fax: 580-510-7044 | |
Daniel L Morgan, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 110 Nw 31st, 3rd Floor, Lawton, OK 73505 Phone: 580-510-7042 Fax: 580-510-7044 |