| John Raizen, MD | |
|
2601 Spencer Rd, Spencer, OK 73084-3649 | |
| (405) 427-2441 | |
| (405) 427-4741 |
| Full Name | John Raizen |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 2601 Spencer Rd, Spencer, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285798793 | NPI | - | NPPES |
| 100249180B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 19490 (Oklahoma) | Primary |
| Entity Name | State Of Oklahoma |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588755532 PECOS PAC ID: 4486558962 Enrollment ID: O20031125000846 |
| Entity Name | Integris Ambulatory Care Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750333936 PECOS PAC ID: 2365408465 Enrollment ID: O20041209000354 |
| Mailing Address | Practice Location Address |
|---|---|
| John Raizen, MD 5300 N Independence Ave, Suite 280, Oklahoma City, OK 73112-5556 Ph: (405) 427-2441 | John Raizen, MD 2601 Spencer Rd, Spencer, OK 73084-3649 Ph: (405) 427-2441 |
Naveena Sesikeran Boindala, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2601 Spencer Rd, Spencer, OK 73084 Phone: 405-427-2441 Fax: 405-427-4741 | |
Kanwaldeep Mann, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2601 Spencer Rd, Spencer, OK 73084 Phone: 405-427-2441 Fax: 405-427-4741 | |
Hashib D. Faruque, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2601 Spencer Rd, Spencer, OK 73084 Phone: 405-427-2441 Fax: 405-427-4741 | |
Linda K Ramer, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2601 Spencer Rd, Spencer, OK 73084 Phone: 405-427-2441 Fax: 405-427-4741 | |
David Tiller, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2601 Spencer Rd, Spencer, OK 73084 Phone: 405-427-2441 Fax: 405-427-4741 | |
Dr. William Oliva, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2601 Spencer Rd, Spencer, OK 73084 Phone: 405-427-2441 Fax: 405-427-4741 |