| Jerry Braziel, PA-C | |
|
519 E State Rd, Fairview, OK 73737-1458 | |
| (580) 227-2585 | |
| Not Available |
| Full Name | Jerry Braziel |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 12 Years |
| Location | 519 E State Rd, Fairview, 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 |
|---|---|---|---|
| 1528462603 | NPI | - | NPPES |
| 200574140A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 2442 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fairview Regional Medical Center Authority | Fairview, OK | Hospital |
| St Mary's Regional Medical Center | Enid, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fairview Regional Medical Center Authority | 4183943186 | 4 |
| Entity Name | Fairview Regional Medical Center Authority |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1033153309 PECOS PAC ID: 4183943186 Enrollment ID: O20150424001440 |
| Entity Name | Fairview Regional Medical Center Authority |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1053357210 PECOS PAC ID: 4183943186 Enrollment ID: O20150424001584 |
| Entity Name | Fairview Regional Medical Center Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316981657 PECOS PAC ID: 4183943186 Enrollment ID: O20150501000163 |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Braziel, PA-C 714 Ninnekah St, Enid, OK 73701-5201 Ph: (580) 603-1762 | Jerry Braziel, PA-C 519 E State Rd, Fairview, OK 73737-1458 Ph: (580) 227-2585 |