| Patrick Russell Gannon, MD | |
|
1 E Clark Bass Blvd, Suite 210, Mcalester, OK 74501-4209 | |
| (918) 421-6987 | |
| (918) 421-6698 |
| Full Name | Patrick Russell Gannon |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 33 Years |
| Location | 1 E Clark Bass Blvd, Mcalester, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790747426 | NPI | - | NPPES |
| 74502A024 | Other | OK | CHAMPUS |
| G67583 | Other | OK | STERLING OPTION 1 |
| 1000176970A | Medicaid | OK | |
| 731310891006 | Other | OK | UNICARE |
| 1324230001 | Other | OK | PALMETTO DME |
| 731310891028 | Other | OK | TRICARE SOUTH |
| 0166707 | Other | OK | UMWA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 20652 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mcalester Regional Health Center | Mcalester, OK | Home health agency |
| Mays Housecall Home Health Of Antlers, Llc | Antlers, OK | Home health agency |
| Compassion Home Care, Inc | Stigler, OK | Home health agency |
| Complete Home Health Of Stigler | Stigler, OK | Home health agency |
| Mcalester Regional Health Center | Mcalester, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mcalester Medical Services Llc | 9931139029 | 21 |
| Entity Name | Mcalester Regional Health Center Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316940034 PECOS PAC ID: 6709796436 Enrollment ID: O20040303001042 |
| Entity Name | Mcalester Medical Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154317998 PECOS PAC ID: 9931139029 Enrollment ID: O20050818000234 |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick Russell Gannon, MD 1245 S Utica Ave, Fl 2, Tulsa, OK 74104-4214 Ph: (918) 579-2300 | Patrick Russell Gannon, MD 1 E Clark Bass Blvd, Suite 210, Mcalester, OK 74501-4209 Ph: (918) 421-6987 |