| Bradley Bibb MD PLLC | |
|
1201 E Hartford Ave Ponca City OK 74601-2018 | |
| (580) 762-1911 | |
| (580) 762-0887 |
| Full Name | Bradley Bibb MD PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1201 E Hartford Ave, Ponca City, Oklahoma |
| Authorized Official Name and Position | Monya York (CONTROLLER) |
| Authorized Official Contact | 8708561202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Bibb MD PLLC 4196 Highway 62 412 Ste A Hardy AR 72542-8002 | Bradley Bibb MD PLLC 1201 E Hartford Ave Ponca City OK 74601-2018 Ph: (580) 762-1911 |
| NPI Number | 1194572040 |
|---|---|
| Provider Enumeration Date | 04/30/2024 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Medicare PECOS PAC ID | 4789715285 |
|---|---|
| Medicare Enrollment ID | O20240520001147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194572040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (NU) | Primary |
| 207Q00000X | Family Medicine | (NU) | Secondary |
| Provider Name | Chadwick Benjamin Ross |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750356861 PECOS PAC ID: 5294753760 Enrollment ID: I20051216000675 |
| Provider Name | Thomas Frasier Engle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124265764 PECOS PAC ID: 4789741851 Enrollment ID: I20090318000128 |
| Provider Name | Kayla D Hardesty |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801075262 PECOS PAC ID: 2668523127 Enrollment ID: I20090624000356 |
| Provider Name | Megan a Lawver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821407180 PECOS PAC ID: 5698997138 Enrollment ID: I20141117001397 |
| Provider Name | Mark Hahn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609895911 PECOS PAC ID: 3375584931 Enrollment ID: I20200427000150 |
| Provider Name | Terri Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750577698 PECOS PAC ID: 3678658473 Enrollment ID: I20231121000551 |
| Provider Name | Donna Jean Mosier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861954984 PECOS PAC ID: 8224534326 Enrollment ID: I20250929001776 |
| Provider Name | Linzy Gavin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881285336 PECOS PAC ID: 8527475086 Enrollment ID: I20251001004719 |
| Provider Name | Chacy Emmanuel Ong Llido |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245125210 PECOS PAC ID: 5193215994 Enrollment ID: I20251110002092 |
Mark Oatman MD PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 N 3rd St, Ponca City, OK 74601 Phone: 580-762-1777 Fax: 580-762-1771 |
Dsk Medical Group, PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 Fairview Ave, Building 3, Ste. 20, Ponca City, OK 74601 Phone: 580-765-6647 Fax: 580-765-6699 |
Bruce Baugher D.O., PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1908 N 14th St, Suite 207, Ponca City, OK 74601 Phone: 580-763-5900 Fax: 580-763-5901 |
Triad Complete Healthcare Z16 LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2703 N 14th St, Ponca City, OK 74601 Phone: 580-749-7846 |
Urgent Care and Family Practice Center of Ponca City LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1715 N 5th St, Ponca City, OK 74601 Phone: 580-762-9292 Fax: 580-762-1660 |
John W. Holden, M.D., P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 427 Fairview Ave, Ponca City, OK 74601 Phone: 580-765-9299 Fax: 580-765-2199 |