| Mark 5 Care Group, Pllc | |
|
1407 N Robinson Ave Oklahoma City OK 73103-4823 | |
| (405) 232-8000 | |
| Not Available |
| Full Name | Mark 5 Care Group, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1407 N Robinson Ave, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Robert William Rader (PRESIDENT) |
| Authorized Official Contact | 4058306673 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark 5 Care Group, Pllc 9801 S Mustang Rd Mustang OK 73064-9531 Ph: (405) 830-6673 | Mark 5 Care Group, Pllc 1407 N Robinson Ave Oklahoma City OK 73103-4823 Ph: (405) 232-8000 |
| NPI Number | 1568722817 |
|---|---|
| Provider Enumeration Date | 05/21/2012 |
| Last Update Date | 05/21/2012 |
| Medicare PECOS PAC ID | 1355598483 |
|---|---|
| Medicare Enrollment ID | O20120824000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568722817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 16912 (Oklahoma) | Primary |
| Provider Name | Brian L Robinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265636633 PECOS PAC ID: 3577463793 Enrollment ID: I20040112000546 |
| Provider Name | Steven G Danley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124193255 PECOS PAC ID: 3274513742 Enrollment ID: I20040723001062 |
| Provider Name | Tamara J Holloway |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790760817 PECOS PAC ID: 9133197379 Enrollment ID: I20040924000214 |
| Provider Name | Mark W Fogle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861485328 PECOS PAC ID: 2264467448 Enrollment ID: I20050927001440 |
| Provider Name | Miles C Langmacher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518942622 PECOS PAC ID: 5092739771 Enrollment ID: I20060126000917 |
| Provider Name | Robert W Rader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669406062 PECOS PAC ID: 7517967565 Enrollment ID: I20061222000186 |
| Provider Name | Ousama Moammar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699981431 PECOS PAC ID: 1658462908 Enrollment ID: I20070801000374 |
| Provider Name | David R Allen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154398410 PECOS PAC ID: 6002976594 Enrollment ID: I20081113000269 |
| Provider Name | Gregory L Blair |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417999616 PECOS PAC ID: 7810084068 Enrollment ID: I20081113000372 |
| Provider Name | Bradley J Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235279373 PECOS PAC ID: 2365595857 Enrollment ID: I20090730000594 |
| Provider Name | Deanna L Ward Plain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760678981 PECOS PAC ID: 9830245729 Enrollment ID: I20090917000387 |
| Provider Name | Nitin Sawheny |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508066127 PECOS PAC ID: 3971627258 Enrollment ID: I20100824000943 |
| Provider Name | Marcus J Smith |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1578769055 PECOS PAC ID: 9931394590 Enrollment ID: I20101109001426 |
| Provider Name | Jodilyn Nicolas Caguioa-aquino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649430737 PECOS PAC ID: 2769655687 Enrollment ID: I20111109000213 |
| Provider Name | Wenjia Zeng |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1659480051 PECOS PAC ID: 6901708056 Enrollment ID: I20111115000330 |
| Provider Name | Kishore Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265626832 PECOS PAC ID: 1951575216 Enrollment ID: I20111122000852 |
| Provider Name | Matthew J Jared |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205060183 PECOS PAC ID: 2264609916 Enrollment ID: I20120119000914 |
| Provider Name | Michael Paul Koehler |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902031487 PECOS PAC ID: 1456508399 Enrollment ID: I20120828000306 |
| Provider Name | Luz H Tono |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417182809 PECOS PAC ID: 9133377005 Enrollment ID: I20120918000762 |
| Provider Name | Peter Kenk Harman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285874834 PECOS PAC ID: 2860394418 Enrollment ID: I20130426000099 |
| Provider Name | Shoaib Ahmad |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255651477 PECOS PAC ID: 8527208040 Enrollment ID: I20130705000364 |
| Provider Name | Teney V John |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932429131 PECOS PAC ID: 6608010574 Enrollment ID: I20130913000683 |
| Provider Name | Nicholas A Sloat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861716474 PECOS PAC ID: 3173767092 Enrollment ID: I20130916000545 |
| Provider Name | Jiss Mathew |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508150715 PECOS PAC ID: 4587881131 Enrollment ID: I20140806000213 |
| Provider Name | Nicholas E Obright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760725584 PECOS PAC ID: 2163731621 Enrollment ID: I20151023000027 |
| Provider Name | Adam D Gardner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689093288 PECOS PAC ID: 2668782541 Enrollment ID: I20151104002664 |
| Provider Name | David Bishop |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932528262 PECOS PAC ID: 6709189525 Enrollment ID: I20160127002475 |
| Provider Name | Mikhail Lomize |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619210622 PECOS PAC ID: 7810291986 Enrollment ID: I20160210001021 |
| Provider Name | John M Huser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861802712 PECOS PAC ID: 3870898026 Enrollment ID: I20160225001099 |
| Provider Name | Benoy Varghese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447694252 PECOS PAC ID: 1658678503 Enrollment ID: I20160321002217 |
| Provider Name | Cole Tunnell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902240716 PECOS PAC ID: 9234352139 Enrollment ID: I20160420001959 |
| Provider Name | Halima N Suria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366739658 PECOS PAC ID: 2264723220 Enrollment ID: I20160622000549 |
| Provider Name | Ashley Michelle Wakelee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891246245 PECOS PAC ID: 2365726973 Enrollment ID: I20170227002350 |
| Provider Name | Julie St John Mahaney |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841679701 PECOS PAC ID: 5890002711 Enrollment ID: I20180703002125 |
| Provider Name | Brindha Gopala Krishnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407208804 PECOS PAC ID: 1052645140 Enrollment ID: I20190624001808 |
| Provider Name | Jack Test |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033648951 PECOS PAC ID: 5193095792 Enrollment ID: I20210929003235 |
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