| Timothy Bushyhead, | |
|
1501 W Rogers Blvd, Skiatook, OK 74070 | |
| (918) 396-4122 | |
| (918) 403-6301 |
| Full Name | Timothy Bushyhead |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 11 Years |
| Location | 1501 W Rogers Blvd, Skiatook, 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 |
|---|---|---|---|
| 1154718807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5953 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Angels Care Home Health Of East Oklahoma | Broken arrow, OK | Home health agency |
| Scissortail Healthcare Llc | Tulsa, OK | Home health agency |
| St John Home Care, Llc | Tulsa, OK | Home health agency |
| St John Owasso | Owasso, OK | Hospital |
| Jane Phillips Memorial Medical Center, Inc | Bartlesville, OK | Hospital |
| St John Medical Center, Inc | Tulsa, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St John Physicians Inc | 2567366495 | 216 |
| Omni Medical Group Inc | 9739080490 | 78 |
| Entity Name | St John Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336194406 PECOS PAC ID: 2567366495 Enrollment ID: O20031121000867 |
| Entity Name | Omni Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174578249 PECOS PAC ID: 9739080490 Enrollment ID: O20040115000897 |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Bushyhead, 1501 W Rogers Blvd, Skiatook, OK 74070-3924 Ph: (918) 396-4122 | Timothy Bushyhead, 1501 W Rogers Blvd, Skiatook, OK 74070 Ph: (918) 396-4122 |
Layne Evan Subera, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 201 E 2nd St, Skiatook, OK 74070 Phone: 918-396-1262 Fax: 918-396-4598 |