| Dr Michael Brent Wiens, MD | |
|
3315 Kethley Rd, Shawnee, OK 74804-9638 | |
| (405) 273-5801 | |
| (405) 878-3794 |
| Full Name | Dr Michael Brent Wiens |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 34 Years |
| Location | 3315 Kethley Rd, Shawnee, 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 |
|---|---|---|---|
| 1750321857 | NPI | - | NPPES |
| 100193970A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 19657 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ssm Health St Anthony Hospital - Shawnee | Shawnee, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saints Medical Group, Llc | 7012914898 | 395 |
| Entity Name | Shawnee Medical Center Clinic, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881648285 PECOS PAC ID: 3870405434 Enrollment ID: O20031103000239 |
| Entity Name | Ssm Health Care Of Oklahoma, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033283932 PECOS PAC ID: 6709771207 Enrollment ID: O20040216000184 |
| Entity Name | Saints Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437195922 PECOS PAC ID: 7012914898 Enrollment ID: O20061109000189 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Brent Wiens, MD Po Box 258884, Oklahoma City, OK 73125-8884 Ph: (405) 231-3857 | Dr Michael Brent Wiens, MD 3315 Kethley Rd, Shawnee, OK 74804-9638 Ph: (405) 273-5801 |
Dr. Grant Lee Mcclune, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3315 Kethley Rd, Shawnee, OK 74804 Phone: 405-273-5801 Fax: 405-878-3814 | |
Dr. Glen Ray Hanson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3315 Kethley Rd, Shawnee, OK 74804 Phone: 405-273-5801 Fax: 405-878-3814 | |
Dr. Matthew Marcus Mctague, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3315 Kethley Rd, Shawnee, OK 74804 Phone: 405-273-5801 Fax: 405-878-3794 |