| Baha Al Deen Abuesheh Md Pc | |
|
1219 A K Street Nw Ardmore OK 73401-1801 | |
| (580) 223-0447 | |
| (580) 223-2989 |
| Full Name | Baha Al Deen Abuesheh Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1219 A K Street Nw, Ardmore, Oklahoma |
| Authorized Official Name and Position | Baha A Abuesheh (OWNER) |
| Authorized Official Contact | 5802230447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baha Al Deen Abuesheh Md Pc Po Box 268996 Oklahoma City OK 73126-8996 Ph: (580) 223-0447 | Baha Al Deen Abuesheh Md Pc 1219 A K Street Nw Ardmore OK 73401-1801 Ph: (580) 223-0447 |
| NPI Number | 1184631756 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 07/09/2012 |
| Medicare PECOS PAC ID | 4183623218 |
|---|---|
| Medicare Enrollment ID | O20061218000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184631756 | NPI | - | NPPES |
| 200096350A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 22441 (Oklahoma) | Primary |
| Provider Name | Baha A Abu-esheh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619909934 PECOS PAC ID: 2668479791 Enrollment ID: I20061101000567 |
| Provider Name | Justin Cole Cheek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760993158 PECOS PAC ID: 1951343730 Enrollment ID: I20180501001202 |
| Provider Name | Carrie Kaye Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124795349 PECOS PAC ID: 7315339215 Enrollment ID: I20220127000682 |
| Provider Name | April D Claxton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821731084 PECOS PAC ID: 9335185701 Enrollment ID: I20220518003004 |
| Provider Name | Connor Petty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497539498 PECOS PAC ID: 0941658421 Enrollment ID: I20231121003252 |
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