| Dr Clinton Graves Wallis, MD | |
|
6516 N Olie Ave Ste A, Oklahoma City, OK 73116-7399 | |
| (405) 486-6960 | |
| (405) 486-6961 |
| Full Name | Dr Clinton Graves Wallis |
|---|---|
| Gender | Male |
| Speciality | Gastroenterology |
| Experience | 27 Years |
| Location | 6516 N Olie Ave Ste A, Oklahoma City, 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 |
|---|---|---|---|
| 1255384483 | NPI | - | NPPES |
| . | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 24646 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Community Hospital, Llc | Oklahoma city, OK | Hospital |
| Integris Baptist Medical Center, Inc | Oklahoma city, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hpi Physicians Llc | 6406048289 | 43 |
| Entity Name | Integris Bass Baptist Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124029293 PECOS PAC ID: 0345151981 Enrollment ID: O20031103000717 |
| Entity Name | Hpi Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205152600 PECOS PAC ID: 6406048289 Enrollment ID: O20101012000705 |
| Entity Name | Integris Ddsi Endoscopy Centers Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1497347934 PECOS PAC ID: 3072928266 Enrollment ID: O20210222001178 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Clinton Graves Wallis, MD 6516 N Olie Ave Ste A, Oklahoma City, OK 73116-7399 Ph: (405) 486-6960 | Dr Clinton Graves Wallis, MD 6516 N Olie Ave Ste A, Oklahoma City, OK 73116-7399 Ph: (405) 486-6960 |
Evelyn Lorents, MD Gastroenterology Medicare: May Accept Medicare Assignments Practice Location: 920 Sl Young Blvd, Oklahoma City, OK 73104 Phone: 405-271-5963 | |
Patrick Bronson Reeves, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 3366 Nw Expressway Ste 550, Oklahoma City, OK 73112 Phone: 405-942-5442 Fax: 405-942-6448 | |
Dr. Jake Lee Evans, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 800 Stanton L Young Blvd, Aat 6300, Oklahoma City, OK 73104 Phone: 405-271-5963 | |
Dr. Shawn Patel, MD Gastroenterology Medicare: Medicare Enrolled Practice Location: 1200 Childrens Ave Ste 14000, Oklahoma City, OK 73104 Phone: 405-271-5211 | |
Metri Haddaden, MD Gastroenterology Medicare: Medicare Enrolled Practice Location: 800 Stanton L Young Blvd # 8425, Oklahoma City, OK 73104 Phone: 405-271-6173 Fax: 410-554-2184 | |
Divya Sharma Divyadarshini, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 800 Stanton L Young Blvd, Oklahoma City, OK 73104 Phone: 405-271-5963 | |
Dr. Philip Barton Miner, Jr., M.D. Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 1000 N Lincoln Blvd, Suite 210, Oklahoma City, OK 73104 Phone: 405-271-4644 Fax: 405-271-3296 |