| Liz Tomichen, | |
|
2017 W I 35 Frontage Rd, Suite 170, Edmond, OK 73013-8550 | |
| (405) 757-3365 | |
| (405) 757-3366 |
| Full Name | Liz Tomichen |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 2017 W I 35 Frontage Rd, Edmond, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639568942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 2425 (Oklahoma) | Primary |
| Entity Name | St. John Physicians, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336194406 PECOS PAC ID: 2567366495 Enrollment ID: O20031121000867 |
| Entity Name | Southwestern Surgical Affiliates, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013169531 PECOS PAC ID: 0941365308 Enrollment ID: O20090218000457 |
| Entity Name | Mercy Hospital Logan County, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306126818 PECOS PAC ID: 4587836200 Enrollment ID: O20121004000289 |
| Entity Name | Tommie Simon MD PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689179715 PECOS PAC ID: 8022363415 Enrollment ID: O20180627000014 |
| Mailing Address | Practice Location Address |
|---|---|
| Liz Tomichen, 2017 W I 35 Frontage Rd, Suite 170, Edmond, OK 73013-8550 Ph: (405) 757-3365 | Liz Tomichen, 2017 W I 35 Frontage Rd, Suite 170, Edmond, OK 73013-8550 Ph: (405) 757-3365 |
Alyx Parrott, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 620 W 15th St, Edmond, OK 73013 Phone: 405-359-0551 |
Haydan Heuermann, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2017 W I 35 Frontage Rd, Edmond, OK 73013 Phone: 405-757-3610 |
Lauren Rae Wheeler, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2017 W I 35 Frontage Rd Ste 140, Edmond, OK 73013 Phone: 405-757-3710 Fax: 405-757-3711 |
Treka B Wenner, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 46 E 15th St, Edmond, OK 73013 Phone: 405-844-5210 |
Mark Patrick Stout, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 18503 N Portland Ave, Edmond, OK 73012 Phone: 405-531-4273 Fax: 405-531-4274 |
Scott Nicholson, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1 S Bryant Ave, Edmond, OK 73034 Phone: 405-341-6100 |
Mrs. Tanya M Keck, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 16205 N Pennsylvania Ave, Access Medical Centers, Edmond, OK 73013 Phone: 405-705-5700 Fax: 405-705-5698 |