| Billy Jack Premo, CRNA | |
| 
					2825 Parklawn Dr, Midwest City, OK 73110-4201  | |
| (405) 360-7576 | |
| Not Available | 
| Full Name | Billy Jack Premo | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 2825 Parklawn Dr, Midwest City, Oklahoma | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1003839911 | NPI | - | NPPES | 
| 430001523 | Other | OK | MEDICARE PIN | 
| 731189454001 | Other | OK | BCBS | 
| 100781950A | Medicaid | OK | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R0025846 (Oklahoma) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Billy Jack Premo, CRNA Po Box 10979, Midwest City, OK 73140-1979 Ph: (405) 360-7576  | Billy Jack Premo, CRNA 2825 Parklawn Dr, Midwest City, OK 73110-4201 Ph: (405) 360-7576  | 
Verle Robert Garnos, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 8121 National Ave, Midwest City, OK 73110 Phone: 405-732-7905 Fax: 405-360-7762  | |
Mr. Peter George Wipfli, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2825 Parklawn Dr, Midwest City, OK 73110 Phone: 405-610-4411  | |
Mr. James Kenneth Randall, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2825 Parklawn Dr, Midwest City, OK 73110 Phone: 405-610-4411  | |
Patrick Todd Liggitt, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2825 Parklawn Dr, Surgery Department, Midwest City, OK 73110 Phone: 405-559-3535 Fax: 405-843-2077  | |
Olusegun Osundele, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2825 Parklawn Dr, Midwest City, OK 73110 Phone: 405-610-8363  | |
Levi Daniel Mcclure, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2825 Parklawn Dr, Midwest City, OK 73110 Phone: 724-388-1783  |