| Dr Rustin Chanc Walters, MD | |
|
10901 E 48th St, Tulsa, OK 74146-5830 | |
| (918) 749-8765 | |
| (918) 392-2155 |
| Full Name | Dr Rustin Chanc Walters |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 10901 E 48th St, Tulsa, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053381467 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 38512 (Oklahoma) | Primary |
| Entity Name | Winchester Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679711261 PECOS PAC ID: 0244134021 Enrollment ID: O20031124000061 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Rustin Chanc Walters, MD 10901 E 48th St, Tulsa, OK 74146-5830 Ph: (918) 749-8765 | Dr Rustin Chanc Walters, MD 10901 E 48th St, Tulsa, OK 74146-5830 Ph: (918) 749-8765 |
Dr. Dae Y Kim, M.D., PH.D Urology Medicare: Accepting Medicare Assignments Practice Location: 1145 S Utica Ave, Suite 202, Tulsa, OK 74104 Phone: 918-579-3130 Fax: 918-579-3139 | |
Dr. Clarence Michael Johnson, D.O. Urology Medicare: Not Enrolled in Medicare Practice Location: 802 S Jackson Ave, Suite 110, Tulsa, OK 74127 Phone: 918-599-4477 Fax: 918-599-4479 | |
Bruce Carlton Stoesser, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 10901 E 48th St S, Tulsa, OK 74146 Phone: 918-749-8765 Fax: 918-392-2155 | |
Kevin Joseph Gancarczyk, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 10901 E 48th St, Tulsa, OK 74146 Phone: 918-749-8765 Fax: 918-392-2155 | |
Jack Steve Miller, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 10901 E 48th St, Tulsa, OK 74146 Phone: 918-749-8765 Fax: 918-392-2155 | |
Dr. Paul G Hagood, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1145 S Utica Ave, Ste 202, Tulsa, OK 74104 Phone: 918-579-3130 Fax: 918-579-3139 |