| Anadarko Indian Health Center | |
|
201 E Parker Mckenzie Drive Anadarko OK 73005-5009 | |
| (405) 247-7900 | |
| (405) 247-4945 |
| Full Name | Anadarko Indian Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 E Parker Mckenzie Drive, Anadarko, Oklahoma |
| Authorized Official Name and Position | Brian R Wren (CEO) |
| Authorized Official Contact | 5803545407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anadarko Indian Health Center 1515 Ne Lawrie Tatum Rd Lawton OK 73507 Ph: (580) 354-5150 | Anadarko Indian Health Center 201 E Parker Mckenzie Drive Anadarko OK 73005-5009 Ph: (405) 247-7900 |
| NPI Number | 1881637403 |
|---|---|
| Provider Enumeration Date | 06/13/2006 |
| Last Update Date | 03/07/2025 |
| Medicare PECOS PAC ID | 7719931559 |
|---|---|
| Medicare Enrollment ID | O20050304000365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881637403 | NPI | - | NPPES |
| 100700620P | Medicaid | OK | |
| 100231960C | Medicaid | OK | |
| 200119930A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |
| Provider Name | Michael A Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831120757 PECOS PAC ID: 7810896156 Enrollment ID: I20040106000184 |
| Provider Name | Timothy T Mccay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245221761 PECOS PAC ID: 2961456538 Enrollment ID: I20050621000935 |
| Provider Name | Sheila Malone Taber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447241971 PECOS PAC ID: 1557311495 Enrollment ID: I20050715000344 |
| Provider Name | George E Erbacher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326039801 PECOS PAC ID: 5991755829 Enrollment ID: I20050720000214 |
| Provider Name | Charles Pradieu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114918778 PECOS PAC ID: 5496641557 Enrollment ID: I20050725001194 |
| Provider Name | Felino A Pascual |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801877055 PECOS PAC ID: 6002801834 Enrollment ID: I20050728000628 |
| Provider Name | John S Dennis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871584060 PECOS PAC ID: 3173594389 Enrollment ID: I20050728000739 |
| Provider Name | Jeffrey L Russell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1942309034 PECOS PAC ID: 5294769568 Enrollment ID: I20050926000755 |
| Provider Name | John D Walton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326096850 PECOS PAC ID: 3375546054 Enrollment ID: I20060907000113 |
| Provider Name | Jasmine R Gaddy |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1881628758 PECOS PAC ID: 7416953336 Enrollment ID: I20061016000421 |
| Provider Name | Myeong S Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497722342 PECOS PAC ID: 0042227266 Enrollment ID: I20070219000272 |
| Provider Name | Bowen C Tzeng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952591760 PECOS PAC ID: 5294807079 Enrollment ID: I20080710000757 |
| Provider Name | Stacy Chemda Goode |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225248784 PECOS PAC ID: 1052497591 Enrollment ID: I20080916000415 |
| Provider Name | Laura L Arrowsmith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083654800 PECOS PAC ID: 9638123631 Enrollment ID: I20081014000674 |
| Provider Name | Jason Pack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861549743 PECOS PAC ID: 3375623887 Enrollment ID: I20090305000362 |
| Provider Name | Ralph Noah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669458741 PECOS PAC ID: 6800966284 Enrollment ID: I20090326000463 |
| Provider Name | Hooby P Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508066473 PECOS PAC ID: 4486705779 Enrollment ID: I20090626000135 |
| Provider Name | Kelly Cole |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699958157 PECOS PAC ID: 0648322024 Enrollment ID: I20090916000496 |
| Provider Name | Jeremy Scott Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255537304 PECOS PAC ID: 5092867762 Enrollment ID: I20090917000124 |
| Provider Name | Damon L Brooks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558583963 PECOS PAC ID: 4587715354 Enrollment ID: I20090917000269 |
| Provider Name | Natasha Nicole Harrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770756173 PECOS PAC ID: 2365580461 Enrollment ID: I20091110000622 |
| Provider Name | Elsa L Marshall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932219342 PECOS PAC ID: 1153491469 Enrollment ID: I20091119000568 |
| Provider Name | Hari S Kapur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750370482 PECOS PAC ID: 7517000540 Enrollment ID: I20100129000658 |
| Provider Name | Maritza Roman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780787317 PECOS PAC ID: 6901949668 Enrollment ID: I20100203000162 |
| Provider Name | Michelle M Ponder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447399415 PECOS PAC ID: 4880787217 Enrollment ID: I20100428000166 |
| Provider Name | Christos Vassiliou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053567784 PECOS PAC ID: 8820120454 Enrollment ID: I20100719000117 |
| Provider Name | Maribel Colon-santiago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942312103 PECOS PAC ID: 9133253289 Enrollment ID: I20100811000985 |
| Provider Name | Hilda J Aviles Vargas |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215112545 PECOS PAC ID: 2062538234 Enrollment ID: I20100924000479 |
| Provider Name | Michael Bryer-ash |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1649205899 PECOS PAC ID: 5597652420 Enrollment ID: I20101005000234 |
| Provider Name | Amy Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962577023 PECOS PAC ID: 2567651789 Enrollment ID: I20110114000419 |
| Provider Name | Marc A Clanton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538190921 PECOS PAC ID: 2062696636 Enrollment ID: I20110405000943 |
| Provider Name | Nina C Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003877754 PECOS PAC ID: 6901833367 Enrollment ID: I20110414000371 |
| Provider Name | Luis E Millan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497068183 PECOS PAC ID: 2264619949 Enrollment ID: I20110606000594 |
| Provider Name | Stephen A Back |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639302060 PECOS PAC ID: 3476723594 Enrollment ID: I20110829000547 |
| Provider Name | Aubrey S Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073827663 PECOS PAC ID: 9133392228 Enrollment ID: I20111107000142 |
| Provider Name | Christopher Nelson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700096435 PECOS PAC ID: 8729266424 Enrollment ID: I20111230000142 |
| Provider Name | Carol Ann Browning |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780864033 PECOS PAC ID: 4385705888 Enrollment ID: I20120123000164 |
| Provider Name | Dennis Kolokolo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477575355 PECOS PAC ID: 5092788471 Enrollment ID: I20120223000719 |
| Provider Name | Gregory D Clift |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255362646 PECOS PAC ID: 7315106119 Enrollment ID: I20120314000717 |
| Provider Name | Elizabeth C Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003183252 PECOS PAC ID: 1456512557 Enrollment ID: I20120417000726 |
| Provider Name | Laura L Alexander |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356601728 PECOS PAC ID: 5193980605 Enrollment ID: I20120709000416 |
| Provider Name | Patrick B O Hayre |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518134352 PECOS PAC ID: 2264695402 Enrollment ID: I20120730000568 |
| Provider Name | Leila Danielle See |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013164268 PECOS PAC ID: 6800059064 Enrollment ID: I20120810000291 |
| Provider Name | Jessica Weber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528397106 PECOS PAC ID: 1456514694 Enrollment ID: I20120822000334 |
| Provider Name | Jeffrey W Shelton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194864074 PECOS PAC ID: 7719141639 Enrollment ID: I20120823000396 |
| Provider Name | Carmen Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558613158 PECOS PAC ID: 8123272572 Enrollment ID: I20130212000179 |
| Provider Name | Jonathon D Kirkland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639315260 PECOS PAC ID: 4789823139 Enrollment ID: I20130726000027 |
| Provider Name | James N Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306089578 PECOS PAC ID: 4284876558 Enrollment ID: I20130911000061 |
| Provider Name | Linda A Mclaughlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659495661 PECOS PAC ID: 1052404258 Enrollment ID: I20131114001594 |
| Provider Name | Anthony E Glydwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104251776 PECOS PAC ID: 6800023300 Enrollment ID: I20131206001703 |
| Provider Name | Brooke White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558679035 PECOS PAC ID: 4688807464 Enrollment ID: I20140516000548 |
| Provider Name | Michael J Golden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952527012 PECOS PAC ID: 9032353313 Enrollment ID: I20140701000579 |
| Provider Name | Nicholas Bull |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487968756 PECOS PAC ID: 6507099389 Enrollment ID: I20140821001827 |
| Provider Name | Peter J Mostert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326346875 PECOS PAC ID: 2860635844 Enrollment ID: I20140828001578 |
| Provider Name | Bo Yon Choi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053551721 PECOS PAC ID: 5890920870 Enrollment ID: I20140925002205 |
| Provider Name | Heidi L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477952976 PECOS PAC ID: 1658693965 Enrollment ID: I20141122000100 |
| Provider Name | David J Ingle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700884491 PECOS PAC ID: 4688561368 Enrollment ID: I20150116001899 |
| Provider Name | Amy L Cohee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659643575 PECOS PAC ID: 5890959563 Enrollment ID: I20150421001059 |
| Provider Name | Kyle G Flowers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063710580 PECOS PAC ID: 2769703107 Enrollment ID: I20150610001387 |
| Provider Name | Tanakorn Songrug |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073847455 PECOS PAC ID: 7416184478 Enrollment ID: I20150615002064 |
| Provider Name | Donald Von Borstel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275887663 PECOS PAC ID: 3779894860 Enrollment ID: I20150617001059 |
| Provider Name | Marcus Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275776965 PECOS PAC ID: 8224250816 Enrollment ID: I20150910000185 |
| Provider Name | Brian E Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407810963 PECOS PAC ID: 6406936970 Enrollment ID: I20160223001453 |
| Provider Name | Nepistance Shoko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780861880 PECOS PAC ID: 3870623986 Enrollment ID: I20160510002134 |
| Provider Name | George Polanco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326019332 PECOS PAC ID: 0244210755 Enrollment ID: I20160713002114 |
| Provider Name | Mark Weissman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336365568 PECOS PAC ID: 3072735810 Enrollment ID: I20160928000827 |
| Provider Name | Ronald A Stillerman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679549166 PECOS PAC ID: 7214958370 Enrollment ID: I20161122000168 |
| Provider Name | Jane Anne Ruger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487650081 PECOS PAC ID: 5890744452 Enrollment ID: I20161207002571 |
| Provider Name | Yves Laventure |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538299425 PECOS PAC ID: 9436295953 Enrollment ID: I20170118000468 |
| Provider Name | Bart M Rowlett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104945526 PECOS PAC ID: 5092602102 Enrollment ID: I20170215002368 |
| Provider Name | Jerrus M Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245619006 PECOS PAC ID: 3678887775 Enrollment ID: I20170220001149 |
| Provider Name | Emad Hamid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457553588 PECOS PAC ID: 7618021999 Enrollment ID: I20170502001404 |
| Provider Name | Kenneth E Mann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851398713 PECOS PAC ID: 7113985441 Enrollment ID: I20170519000382 |
| Provider Name | Adam Boice Foster |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811230311 PECOS PAC ID: 6406123504 Enrollment ID: I20170526000322 |
| Provider Name | Blake Edward Weaver |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497785893 PECOS PAC ID: 6103890975 Enrollment ID: I20170629001468 |
| Provider Name | Tyler Jay Robertson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891216388 PECOS PAC ID: 8123390424 Enrollment ID: I20170822001154 |
| Provider Name | Brad Victor Nuttall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699290478 PECOS PAC ID: 7810261690 Enrollment ID: I20170918000843 |
| Provider Name | Kevin L Hamm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578657623 PECOS PAC ID: 8022919620 Enrollment ID: I20171014000017 |
| Provider Name | Ali Saleem |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639448020 PECOS PAC ID: 1759501562 Enrollment ID: I20171207001100 |
| Provider Name | Craig White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417278573 PECOS PAC ID: 2365757481 Enrollment ID: I20180104000432 |
| Provider Name | Natalia Solomon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003173915 PECOS PAC ID: 6709141328 Enrollment ID: I20180601001555 |
| Provider Name | Samuel B Hancock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063672608 PECOS PAC ID: 3577699073 Enrollment ID: I20180614000232 |
| Provider Name | Marci Story |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619913019 PECOS PAC ID: 3375513377 Enrollment ID: I20180625001839 |
| Provider Name | Julia D Knarreborg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952662363 PECOS PAC ID: 3173828803 Enrollment ID: I20180703001304 |
| Provider Name | Tara Van Drunen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598787442 PECOS PAC ID: 1557685757 Enrollment ID: I20180713000476 |
| Provider Name | Jessica Meador |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952751455 PECOS PAC ID: 5597012310 Enrollment ID: I20180724003254 |
| Provider Name | Laura M Young |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720048267 PECOS PAC ID: 9436109477 Enrollment ID: I20180813001041 |
| Provider Name | Nathalie V Andry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992022305 PECOS PAC ID: 8921132903 Enrollment ID: I20180816000632 |
| Provider Name | Morris Kopels |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699849687 PECOS PAC ID: 8325218712 Enrollment ID: I20180828002514 |
| Provider Name | Catherine Shaeffer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811251499 PECOS PAC ID: 4385872175 Enrollment ID: I20180830000526 |
| Provider Name | John Josiah Harrison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386630499 PECOS PAC ID: 8628170172 Enrollment ID: I20180904001962 |
| Provider Name | Steven Matthew Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366733404 PECOS PAC ID: 0042536575 Enrollment ID: I20180912003056 |
| Provider Name | Jeff Salsieder |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508240300 PECOS PAC ID: 2860743424 Enrollment ID: I20180920000380 |
| Provider Name | Kyle F Summers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346663135 PECOS PAC ID: 6406119593 Enrollment ID: I20180926000466 |
| Provider Name | Aun Ali Hussain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184056202 PECOS PAC ID: 5092067439 Enrollment ID: I20181011002458 |
| Provider Name | Ronald Pritchard |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1417998774 PECOS PAC ID: 2668426578 Enrollment ID: I20181016001073 |
| Provider Name | Shawn D Grant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043214497 PECOS PAC ID: 6204877079 Enrollment ID: I20181211000646 |
| Provider Name | Angela Battese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023487311 PECOS PAC ID: 8921347626 Enrollment ID: I20190225000805 |
| Provider Name | Janet Ilidan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831599539 PECOS PAC ID: 4587903976 Enrollment ID: I20190301000956 |
| Provider Name | Joel Massey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396805966 PECOS PAC ID: 7618115130 Enrollment ID: I20190329000883 |
| Provider Name | Michael J Walters |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962768341 PECOS PAC ID: 6901198951 Enrollment ID: I20190621000329 |
| Provider Name | Natosha Monfore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912343435 PECOS PAC ID: 6800129651 Enrollment ID: I20190709001084 |
| Provider Name | Randy W Cox |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467939249 PECOS PAC ID: 1153659164 Enrollment ID: I20190828001611 |
| Provider Name | Marie L Duan Meservy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699018424 PECOS PAC ID: 0749588374 Enrollment ID: I20190830002587 |
| Provider Name | Eugenio Erquiaga |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528005048 PECOS PAC ID: 6002947033 Enrollment ID: I20190923000256 |
| Provider Name | Jane Walta |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477881712 PECOS PAC ID: 1951632462 Enrollment ID: I20191015002038 |
| Provider Name | Nicholas A Strle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851703185 PECOS PAC ID: 4587999354 Enrollment ID: I20191115001941 |
| Provider Name | Cameron P Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831515287 PECOS PAC ID: 7214264449 Enrollment ID: I20191116000000 |
| Provider Name | Robert L Cirillo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356305973 PECOS PAC ID: 0840238994 Enrollment ID: I20191231001741 |
| Provider Name | Mary S Kendrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598705626 PECOS PAC ID: 8921991803 Enrollment ID: I20200103000214 |
| Provider Name | Jeff Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073933289 PECOS PAC ID: 2567899552 Enrollment ID: I20200304001706 |
| Provider Name | Mckinley C Lawson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104137181 PECOS PAC ID: 6103056759 Enrollment ID: I20200609000592 |
| Provider Name | Nabil A Yassa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467438911 PECOS PAC ID: 8729020839 Enrollment ID: I20200609000648 |
| Provider Name | Christopher D Roman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033266838 PECOS PAC ID: 1850482761 Enrollment ID: I20200701000532 |
| Provider Name | Shari C Fox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609994169 PECOS PAC ID: 5294152963 Enrollment ID: I20200826000907 |
| Provider Name | Taylor Rae Erhardt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831713957 PECOS PAC ID: 6305263518 Enrollment ID: I20200902003080 |
| Provider Name | Crystal B Kronenberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558690719 PECOS PAC ID: 8527346758 Enrollment ID: I20201002001987 |
| Provider Name | Dimple Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306023809 PECOS PAC ID: 5991952178 Enrollment ID: I20210114000460 |
| Provider Name | Matthew Bledsoe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295116721 PECOS PAC ID: 6608188024 Enrollment ID: I20210702000599 |
| Provider Name | Rafel Alvarez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215383005 PECOS PAC ID: 7618247586 Enrollment ID: I20210706000944 |
| Provider Name | Tyler Braaten |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134507957 PECOS PAC ID: 3577964352 Enrollment ID: I20210708000016 |
| Provider Name | Philip Paul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821524364 PECOS PAC ID: 1951678499 Enrollment ID: I20210826002896 |
| Provider Name | Samina Zafar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659853851 PECOS PAC ID: 3274887401 Enrollment ID: I20211222000717 |
| Provider Name | Dustin W Cheney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225492606 PECOS PAC ID: 9133523418 Enrollment ID: I20220324000946 |
| Provider Name | Brittany Ann Claudean Jane Napoleon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740842863 PECOS PAC ID: 4880027689 Enrollment ID: I20220426002741 |
| Provider Name | Frank Hebroni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437509494 PECOS PAC ID: 0941609754 Enrollment ID: I20220706002718 |
| Provider Name | Nancy N Emelife |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992124093 PECOS PAC ID: 6608298245 Enrollment ID: I20220708000678 |
| Provider Name | Oliver Cvitanic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538267208 PECOS PAC ID: 2567490204 Enrollment ID: I20221205003181 |
| Provider Name | Joseph Eble |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972766806 PECOS PAC ID: 9436205952 Enrollment ID: I20230102000149 |
| Provider Name | Allen Molloy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720121684 PECOS PAC ID: 4284726449 Enrollment ID: I20230307003381 |
| Provider Name | Michael Edward Sabatino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447425673 PECOS PAC ID: 1951571736 Enrollment ID: I20230526000985 |
| Provider Name | Aman Mittal |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699126425 PECOS PAC ID: 9931521093 Enrollment ID: I20230530003341 |
| Provider Name | Azka Arif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417478371 PECOS PAC ID: 1850758574 Enrollment ID: I20230612000150 |
| Provider Name | Austin Marsh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346773850 PECOS PAC ID: 7911389002 Enrollment ID: I20230624000094 |
| Provider Name | Aubrey Slaughter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851596936 PECOS PAC ID: 4486898145 Enrollment ID: I20230913000750 |
| Provider Name | Erin Horsley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134405939 PECOS PAC ID: 2668786039 Enrollment ID: I20240103000811 |
| Provider Name | Kimberly Winsor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447678016 PECOS PAC ID: 7517221948 Enrollment ID: I20240103001136 |
| Provider Name | Jessica Millsap |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710207451 PECOS PAC ID: 1759527559 Enrollment ID: I20240103003939 |
| Provider Name | Jeremiah M Daniel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316441652 PECOS PAC ID: 1052731155 Enrollment ID: I20240213003182 |
| Provider Name | Nedeljko J Uncanin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346744737 PECOS PAC ID: 1052778123 Enrollment ID: I20240305003116 |
| Provider Name | Tisha Singer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104269307 PECOS PAC ID: 9638396328 Enrollment ID: I20240903004181 |
| Provider Name | Vishtasb Ariazand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285922922 PECOS PAC ID: 0840588463 Enrollment ID: I20241120001457 |
| Provider Name | Chad G Thompson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447452560 PECOS PAC ID: 7618020264 Enrollment ID: I20241211000070 |
| Provider Name | Kevin Stieb |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740833227 PECOS PAC ID: 4486982642 Enrollment ID: I20241217001175 |
| Provider Name | Robert G Moult |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457334724 PECOS PAC ID: 6103715974 Enrollment ID: I20241217003218 |
| Provider Name | Jessica M Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811103344 PECOS PAC ID: 0648675660 Enrollment ID: I20250325002396 |
| Provider Name | Joseph M Gumbrill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518598739 PECOS PAC ID: 4082131073 Enrollment ID: I20250502001652 |
Variety Care, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 718 W Petree Rd, Anadarko, OK 73005 Phone: 405-632-6688 | |
Southern Plains Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1104 E Central Blvd, Anadarko, OK 73005 Phone: 405-247-6685 | |
Grady Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 E Central Blvd, Anadarko, OK 73005 Phone: 405-247-2551 | |
Variety Care, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 718 W Petree Rd, Anadarko, OK 73005 Phone: 405-632-6688 | |
Rural Wellness Anadarko Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1002 E Central Blvd, Anadarko, OK 73005 Phone: 405-247-2551 Fax: 405-247-8528 | |
Rural Wellness Anadarko Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 412 Se 11th Street, Anadarko, OK 73005 Phone: 405-247-9500 Fax: 405-247-9505 | |
Variety Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 718 W Petree Rd, Anadarko, OK 73005 Phone: 405-632-6688 |