| Aetherius Medical Llc | |
|
408 N Main St Noble OK 73068-9574 | |
| (405) 339-5261 | |
| Not Available |
| Full Name | Aetherius Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 408 N Main St, Noble, Oklahoma |
| Authorized Official Name and Position | Krysten Mescan (OWNER - FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 4053001476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aetherius Medical Llc 408 N Main St Noble OK 73068-9574 Ph: (405) 300-1476 | Aetherius Medical Llc 408 N Main St Noble OK 73068-9574 Ph: (405) 339-5261 |
| NPI Number | 1851103063 |
|---|---|
| Provider Enumeration Date | 01/23/2025 |
| Last Update Date | 03/18/2025 |
| Medicare PECOS PAC ID | 9335662881 |
|---|---|
| Medicare Enrollment ID | O20250326000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851103063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Patrick Michael Cody |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912969494 PECOS PAC ID: 1850312638 Enrollment ID: I20051227000123 |
| Provider Name | Cynthia N Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235730581 PECOS PAC ID: 7719390012 Enrollment ID: I20210105002945 |
| Provider Name | Krysten Ashley Mescan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972257798 PECOS PAC ID: 8527434752 Enrollment ID: I20221013000689 |
Noble Family Healthcare Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 S. Main, Noble, OK 73068 Phone: 405-872-5403 Fax: 405-872-5407 | |
Noble Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 408 N Main St, Noble, OK 73068 Phone: 405-677-3378 | |
Noble Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 E Maguire Rd, Ste 4000, Noble, OK 73068 Phone: 405-872-9494 Fax: 405-872-9464 |