| Dr Kyle C Wooderson, DO | |
|
601 E 13th St, Ste H, Grove, OK 74344-2989 | |
| (918) 786-7300 | |
| (918) 786-7303 |
| Full Name | Dr Kyle C Wooderson |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 17 Years |
| Location | 601 E 13th St, Grove, 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 |
|---|---|---|---|
| 1508095977 | NPI | - | NPPES |
| 200254780A | Medicaid | OK | |
| 200505990O | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 4824 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Integris Grove Hospital | Grove, OK | Hospital |
| Integris Miami Hospital | Miami, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Integris Ambulatory Care Corporation | 2365408465 | 564 |
| Entity Name | Ahs Oklahoma Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235182775 PECOS PAC ID: 9436122496 Enrollment ID: O20040817001197 |
| Entity Name | Integris Ambulatory Care Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750333936 PECOS PAC ID: 2365408465 Enrollment ID: O20041209000354 |
| Entity Name | Mercy Clinic Oklahoma Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386874550 PECOS PAC ID: 1153468921 Enrollment ID: O20091027000755 |
| Entity Name | St Anthony Shawnee Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619260411 PECOS PAC ID: 1052567328 Enrollment ID: O20121015000218 |
| Entity Name | Oklahoma Emergency Physician Partners Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891039764 PECOS PAC ID: 0345493649 Enrollment ID: O20130118000115 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kyle C Wooderson, DO 5300 N Independence Ave, 280, Oklahoma City, OK 73112-5556 Ph: (918) 786-7300 | Dr Kyle C Wooderson, DO 601 E 13th St, Ste H, Grove, OK 74344-2989 Ph: (918) 786-7300 |
Ms. Haley Adams, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 115 W 13th St, Grove, OK 74344 Phone: 918-786-7300 Fax: 918-786-7303 | |
Douglas Allen Ohlstrom, M.D., F.A.C.S. Surgery Medicare: Not Enrolled in Medicare Practice Location: 900 E 13th St, Suite 102, Grove, OK 74344 Phone: 918-786-7200 Fax: 918-786-7212 |