| Elaine Mary Mader, MD | |
|
200 2nd Ave Sw, Miami, OK 74354-6830 | |
| (918) 542-6611 | |
| (405) 553-5633 |
| Full Name | Elaine Mary Mader |
|---|---|
| Gender | Female |
| Speciality | Emergency Medicine |
| Location | 200 2nd Ave Sw, Miami, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467427591 | NPI | - | NPPES |
| 500156005 | Medicaid | MO | |
| 100193100A | Medicaid | OK | |
| 100699440M | Medicaid | OK | |
| 209879907 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 16786 (Oklahoma) | Primary |
| Entity Name | Emergency Services Of Oklahoma Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215249891 PECOS PAC ID: 8123209012 Enrollment ID: O20110225000085 |
| Entity Name | South Central Emergency Services, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558663724 PECOS PAC ID: 8224212949 Enrollment ID: O20110405000201 |
| Mailing Address | Practice Location Address |
|---|---|
| Elaine Mary Mader, MD 200 2nd Ave Sw, Miami, OK 74354-6830 Ph: (918) 542-6611 | Elaine Mary Mader, MD 200 2nd Ave Sw, Miami, OK 74354-6830 Ph: (918) 542-6611 |
James M Le, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 200 2nd Ave Sw, Miami, OK 74354 Phone: 918-542-6611 | |
John Clark Osborn, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 310 2nd Ave Sw, 107-b, Miami, OK 74354 Phone: 918-540-7730 Fax: 918-540-7797 | |
Merlin Joe Kilbury Iii, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 200 2nd Ave Sw, Miami, OK 74354 Phone: 918-540-7573 Fax: 918-540-7590 |