Jason Tyler Gordon Graham, NP | |
104 Wall St, Poteau, OK 74953-4405 | |
(918) 635-3508 | |
(918) 635-3550 |
Full Name | Jason Tyler Gordon Graham |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 104 Wall St, Poteau, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285317735 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 222349 (Arkansas) | Primary |
Entity Name | Ideal Option Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457788275 PECOS PAC ID: 6709013105 Enrollment ID: O20200220002283 |
Mailing Address | Practice Location Address |
---|---|
Jason Tyler Gordon Graham, NP 105 Wall St, Poteau, OK 74953-4433 Ph: (918) 635-3566 | Jason Tyler Gordon Graham, NP 104 Wall St, Poteau, OK 74953-4405 Ph: (918) 635-3508 |
Lois L Gotes, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1013 Dewey Ave, Poteau, OK 74953 Phone: 918-647-2929 Fax: 918-647-2288 | |
Mr. Timothy Ray Olive, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2011 N Broadway St, Poteau, OK 74953 Phone: 918-647-7416 Fax: 918-647-3508 | |
Jeanne R Guinn, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 204 Wall St Ste A, Poteau, OK 74953 Phone: 918-647-2155 Fax: 918-967-4582 | |
Tracy Leann Morgan, APRN FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1301 S Broadway Ave Ste 5, Poteau, OK 74953 Phone: 918-210-0167 Fax: 918-564-2719 | |
Mrs. Kimberly Kay Cobb, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 210 W Robert St, Poteau, OK 74953 Phone: 918-649-0069 Fax: 918-649-0067 | |
Emily L Harrah, APRN-FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1120 Tarby Rd, Poteau, OK 74953 Phone: 918-647-2155 Fax: 918-647-4095 |