| Kash K. Biddle, Do, Pllc | |
|
3300 S Aspen Ave Suite C Broken Arrow OK 74012-7501 | |
| (918) 455-2416 | |
| (918) 455-7546 |
| Full Name | Kash K. Biddle, Do, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3300 S Aspen Ave, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Kash K. Biddle (OWNER/PHYSICIAN) |
| Authorized Official Contact | 9184552416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kash K. Biddle, Do, Pllc 3300 S Aspen Ave Suite C Broken Arrow OK 74012-7501 Ph: (918) 455-2416 | Kash K. Biddle, Do, Pllc 3300 S Aspen Ave Suite C Broken Arrow OK 74012-7501 Ph: (918) 455-2416 |
| NPI Number | 1477714590 |
|---|---|
| Provider Enumeration Date | 06/20/2008 |
| Last Update Date | 06/20/2008 |
| Medicare PECOS PAC ID | 0749353316 |
|---|---|
| Medicare Enrollment ID | O20080716000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477714590 | NPI | - | NPPES |
| 100145710A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2152 (Oklahoma) | Primary |
| Provider Name | Kash K Biddle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073566659 PECOS PAC ID: 8224101894 Enrollment ID: I20080716000227 |
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