| Dr Ian P Goodman, MD | |
|
12455 E 100th St N, Owasso, OK 74055-4674 | |
| (918) 272-9464 | |
| (918) 272-9512 |
| Full Name | Dr Ian P Goodman |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 13 Years |
| Location | 12455 E 100th St N, Owasso, 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 |
|---|---|---|---|
| 1134495666 | NPI | - | NPPES |
| 14123871 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 27449 (Nebraska) | Secondary |
| 207X00000X | Orthopaedic Surgery | ME133594 (Florida) | Secondary |
| 207X00000X | Orthopaedic Surgery | 39030 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St John Owasso | Owasso, OK | Hospital |
| Bailey Medical Center, Llc | Owasso, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tulsa Bone And Joint Associates Pc | 9335033802 | 86 |
| Entity Name | Tulsa Bone & Joint Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154373132 PECOS PAC ID: 9335033802 Enrollment ID: O20040214000207 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ian P Goodman, MD 4802 S 109th East Ave, Tulsa, OK 74146-5822 Ph: (918) 392-1400 | Dr Ian P Goodman, MD 12455 E 100th St N, Owasso, OK 74055-4674 Ph: (918) 272-9464 |
Brian C. Howard, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 13616 E 103rd St N, Owasso, OK 74055 Phone: 918-481-2767 | |
Dr. Terrill H Simmons, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 12455 E 100th St N, Suite 260, Owasso, OK 74055 Phone: 918-272-9464 Fax: 918-274-5569 | |
Dr. Bradley J. Lawson, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 13616 E 103rd St N Ste B, Owasso, OK 74055 Phone: 918-272-4488 Fax: 918-481-7611 |