| Jen Wong, MD | |
|
3500 E Frank Phillips Blvd, Bartlesville, OK 74006-2411 | |
| (918) 333-7200 | |
| Not Available |
| Full Name | Jen Wong |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 3500 E Frank Phillips Blvd, Bartlesville, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801830161 | NPI | - | NPPES |
| 100312770A | Medicaid | KS | |
| 100019560A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 19751 (Oklahoma) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | 04-26325 (Kansas) | Secondary |
| Entity Name | Radiological Services, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659311470 PECOS PAC ID: 9739130139 Enrollment ID: O20050411001312 |
| Mailing Address | Practice Location Address |
|---|---|
| Jen Wong, MD 4500 S Garnett Rd, Ste 300, Tulsa, OK 74146-5229 Ph: (770) 514-2773 | Jen Wong, MD 3500 E Frank Phillips Blvd, Bartlesville, OK 74006-2411 Ph: (918) 333-7200 |
Dr. Maurice D Krause Jr., MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3500 Frank Phillips Blvd, Bartlesville, OK 74005 Phone: 918-331-1857 Fax: 918-331-1698 | |
Jeremiah Morgan Daniel, DO Radiology Medicare: Accepting Medicare Assignments Practice Location: 3550 E Frank Phillips Blvd, Bartlesville, OK 74006 Phone: 918-333-7200 | |
Jim Bolene, MD Radiology Medicare: Medicare Enrolled Practice Location: 3500 E Frank Phillips Blvd, Bartlesville, OK 74006 Phone: 918-333-7200 | |
John Anthony Yeabower Jr., MD Radiology Medicare: Medicare Enrolled Practice Location: 3500 E Frank Phillips Blvd, Bartlesville, OK 74006 Phone: 918-333-7200 |