| Bedside Manner LLC | |
|
550 W 125th Pl S Ste 202 Glenpool OK 74033-5026 | |
| (918) 528-5500 | |
| Not Available |
| Full Name | Bedside Manner LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 550 W 125th Pl S Ste 202, Glenpool, Oklahoma |
| Authorized Official Name and Position | Travis Wolff (CEO) |
| Authorized Official Contact | 9185285500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bedside Manner LLC 303 E A St Jenks OK 74037-4285 | Bedside Manner LLC 550 W 125th Pl S Ste 202 Glenpool OK 74033-5026 Ph: (918) 528-5500 |
| NPI Number | 1336983899 |
|---|---|
| Provider Enumeration Date | 06/20/2024 |
| Last Update Date | 09/02/2026 |
| Certification Date | 09/02/2026 |
| Medicare PECOS PAC ID | 7719423250 |
|---|---|
| Medicare Enrollment ID | O20240722000589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336983899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 261QI0500X | Clinic/center - Infusion Therapy | () | Secondary |
| Provider Name | Scott M Anderson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154397149 PECOS PAC ID: 7214988468 Enrollment ID: I20050204000070 |
| Provider Name | Theron Joseph Bliss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538364245 PECOS PAC ID: 0446420459 Enrollment ID: I20110831000235 |
| Provider Name | Carrie Irene Cross |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477922599 PECOS PAC ID: 4385949908 Enrollment ID: I20160219000495 |
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