| Tina C Small, MD | |
|
5109 W Gore Blvd, Lawton, OK 73505-5998 | |
| (580) 699-2495 | |
| (580) 699-2515 |
| Full Name | Tina C Small |
|---|---|
| Gender | Female |
| Speciality | Physical Medicine And Rehabilitation |
| Experience | 27 Years |
| Location | 5109 W Gore Blvd, Lawton, 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 |
|---|---|---|---|
| 1720074255 | NPI | - | NPPES |
| P00166228 | Other | RAILROAD MEDICARE | |
| 487023200 | Other | OK | DOL |
| 200038730A | Medicaid | OK | |
| 7664685 | Other | OK | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 24054 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Comanche County Memorial Hospital | Lawton, OK | Hospital |
| Duncan Regional Hospital, Inc | Duncan, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Spine Care Of Oklahoma Llc | 3476549114 | 5 |
| Entity Name | Spine Care Of Oklahoma Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033302906 PECOS PAC ID: 3476549114 Enrollment ID: O20040420001624 |
| Mailing Address | Practice Location Address |
|---|---|
| Tina C Small, MD 4301 Wilson St, Fort Sill, OK 73503-4472 Ph: (580) 558-8497 | Tina C Small, MD 5109 W Gore Blvd, Lawton, OK 73505-5998 Ph: (580) 699-2495 |
Sandra Jean Koch, MD Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 233 Valleyview Dr, Lawton, OK 73507 Phone: 580-529-2355 | |
Gregory D Powell, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 3201 W Gore Blvd Ste 104, Lawton, OK 73505 Phone: 580-250-6659 Fax: 580-250-5249 | |
Dr. Zachary Michael Berry, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 3201 W Gore Blvd, Suite 104, Lawton, OK 73505 Phone: 580-250-6659 Fax: 580-250-5249 |