| Blake a Badgett MD PC | |
|
3731 Legacy Weatherford OK 73096-9746 | |
| (580) 772-6777 | |
| (580) 772-2510 |
| Full Name | Blake a Badgett MD PC |
|---|---|
| Speciality | Family Medicine |
| Location | 3731 Legacy, Weatherford, Oklahoma |
| Authorized Official Name and Position | Blake Allen Badgett (OWNER) |
| Authorized Official Contact | 5807726777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blake a Badgett MD PC 3731 Legacy Weatherford OK 73096-0000 Ph: (580) 772-6777 | Blake a Badgett MD PC 3731 Legacy Weatherford OK 73096-9746 Ph: (580) 772-6777 |
| NPI Number | 1215148044 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 02/10/2016 |
| Medicare PECOS PAC ID | 9537223128 |
|---|---|
| Medicare Enrollment ID | O20090127000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215148044 | NPI | - | NPPES |
| 100090510 A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 22800 (Oklahoma) | Primary |
| Provider Name | Blake Badgett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376636084 PECOS PAC ID: 8527094804 Enrollment ID: I20110318000378 |
| Provider Name | Stephanie D Yoder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841695673 PECOS PAC ID: 7214250836 Enrollment ID: I20150106000929 |
| Provider Name | Tosha Dawn Villines-robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720598782 PECOS PAC ID: 5193082568 Enrollment ID: I20171121002636 |
| Provider Name | Taylor M Lewallen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881308450 PECOS PAC ID: 1153794797 Enrollment ID: I20230302001012 |
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