| Michael Sean O'dell, CRNA | |
| 
					5501 N Portland Ave, Oklahoma City, OK 73112-2074  | |
| (405) 604-6000 | |
| Not Available | 
| Full Name | Michael Sean O'dell | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 5501 N Portland Ave, Oklahoma City, Oklahoma | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1013284397 | NPI | - | NPPES | 
| 200421920A | Medicaid | OK | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R0067052 (Oklahoma) | Primary | 
| Entity Name | Board Of Regents Of The University Of Oklahoma - Ou Physicians | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1801869250 PECOS PAC ID: 2860304334 Enrollment ID: O20031103000607  | 
| Entity Name | Ou Health Partners Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1528642642 PECOS PAC ID: 5991105876 Enrollment ID: O20210615000618  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Michael Sean O'dell, CRNA Po Box 248875, Oklahoma City, OK 73124-8875 Ph: (918) 392-2944  | Michael Sean O'dell, CRNA 5501 N Portland Ave, Oklahoma City, OK 73112-2074 Ph: (405) 604-6000  | 
Traci Renee Wilmarth, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9713 Lakecrest Dr, Oklahoma City, OK 73159 Phone: 405-213-5351  | |
Paul Jason Bradley, RN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Stanton L Young Blvd # Wp1140, Oklahoma City, OK 73104 Phone: 405-271-4351 Fax: 405-271-8695  | |
Mr. Darryl W. Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 100 Ne 85th St, Oklahoma City, OK 73114 Phone: 405-631-3085 Fax: 405-616-2679  | |
Ivan Kozhulenko, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Stanton L Young Blvd Ste Wp1140, Oklahoma City, OK 73104 Phone: 405-271-4351 Fax: 405-271-8695  | |
Jasilin Hall, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 5501 N Portland Ave, Oklahoma City, OK 73112 Phone: 405-604-6000  | |
Robert Lee Rawls, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9600 Broadway Ext, Oklahoma City, OK 73114 Phone: 405-715-3610 Fax: 405-715-3612  |