| Dr Lisa Diane Macek, MD | |
| 
					2950 S Elm Pl, Suite 160, Broken Arrow, OK 74012-7877  | |
| (918) 449-3750 | |
| (918) 449-3755 | 
| Full Name | Dr Lisa Diane Macek | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 2950 S Elm Pl, Broken Arrow, Oklahoma | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1245521889 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 28585 (Oklahoma) | Primary | 
| Entity Name | Warren Clinic Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1174582282 PECOS PAC ID: 8820900293 Enrollment ID: O20031104000252  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Lisa Diane Macek, MD 6600 S Yale Ave, Suite 1400, Tulsa, OK 74136-3347 Ph: (918) 488-6001  | Dr Lisa Diane Macek, MD 2950 S Elm Pl, Suite 160, Broken Arrow, OK 74012-7877 Ph: (918) 449-3750  | 
Latina D Shelley, APRN, CPNP-PC Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 817 S Elm Pl Ste 106, Broken Arrow, OK 74012 Phone: 918-928-5437 Fax: 888-720-8944  | |
Dr. Suresh Bharani,  Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3300 S Aspen Ave, Suite B, Broken Arrow, OK 74012 Phone: 918-455-4140  | |
Dr. Douglas W Richmond, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 5795 S Elm Pl, Broken Arrow, OK 74011 Phone: 918-716-5437  | |
Anne K Harrington, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2950 S Elm Pl, Ste 430, Broken Arrow, OK 74012 Phone: 918-449-4061 Fax: 918-449-4065  | |
Dr. Carl Erwin Pfanstiel, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1220 N Elm Place, Broken Arrow, OK 74012 Phone: 918-258-1955 Fax: 918-251-5802  | |
Julie Gail Sullivan, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1615 S Eucalyptus Ave, Suite 210, Broken Arrow, OK 74012 Phone: 918-254-6822 Fax: 918-254-6823  |