| Lea Sarah Humphrey, DO | |
|
1203 E Ross Byp, Tahlequah, OK 74464-4133 | |
| (918) 453-1234 | |
| (918) 453-9107 |
| Full Name | Lea Sarah Humphrey |
|---|---|
| Gender | Female |
| Speciality | Otolaryngology |
| Experience | 15 Years |
| Location | 1203 E Ross Byp, Tahlequah, Oklahoma |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649584855 | NPI | - | NPPES |
| 200593430A | Medicaid | OK |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northeastern Health System | Tahlequah, OK | Hospital |
| Cherokee Nation W W Hastings Indian Hospital | Tahlequah, OK | Hospital |
| Integris Grove Hospital | Grove, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northeastern Health System | 1456255025 | 98 |
| Northeastern Oklahoma Community Health Centers, Inc | 3678482635 | 32 |
| Cherokee Nation | 5799698742 | 369 |
| Entity Name | Northeastern Oklahoma Community Health Centers, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518070481 PECOS PAC ID: 3678482635 Enrollment ID: O20031104000417 |
| Entity Name | Northeastern Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457574170 PECOS PAC ID: 1456255025 Enrollment ID: O20031125000250 |
| Entity Name | Tahlequah Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881960771 PECOS PAC ID: 4082861349 Enrollment ID: O20120822000336 |
| Mailing Address | Practice Location Address |
|---|---|
| Lea Sarah Humphrey, DO 100 Mercy Way, Ste 560, Joplin, MO 64804-4524 Ph: (417) 556-8555 | Lea Sarah Humphrey, DO 1203 E Ross Byp, Tahlequah, OK 74464-4133 Ph: (918) 453-1234 |
Tracey Way Childers, D.O. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1203 E Ross Byp, Suite A, Tahlequah, OK 74464 Phone: 918-453-1234 Fax: 918-453-9107 | |
Susan K Anderson, DO Otolaryngology Medicare: Medicare Enrolled Practice Location: 1203 E Ross Byp, Suite A, Tahlequah, OK 74464 Phone: 918-453-1234 Fax: 918-453-9107 | |
Charles Joseph Wine, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464 Phone: 918-458-3360 Fax: 918-458-3511 |