| Rural Wellness Stroud Inc. | |
|
2308 W Highway 66 Stroud OK 74079-6729 | |
| (918) 968-3571 | |
| (918) 968-4814 |
| Full Name | Rural Wellness Stroud Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2308 W Highway 66, Stroud, Oklahoma |
| Authorized Official Name and Position | Elizabeth Pusey (PRESIDENT) |
| Authorized Official Contact | 9493224337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rural Wellness Stroud Inc. 361 Hospital Rd Ste 528 Newport Beach CA 92663-3526 Ph: (949) 322-4337 | Rural Wellness Stroud Inc. 2308 W Highway 66 Stroud OK 74079-6729 Ph: (918) 968-3571 |
| NPI Number | 1609532282 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 11/09/2021 |
| Medicare PECOS PAC ID | 7113310491 |
|---|---|
| Medicare Enrollment ID | O20220209000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609532282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | James Rooks |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841269792 PECOS PAC ID: 7012918915 Enrollment ID: I20070119000199 |
| Provider Name | Anna Wanahita |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073650537 PECOS PAC ID: 7214037860 Enrollment ID: I20070711000514 |
| Provider Name | Suraj Suku |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891833505 PECOS PAC ID: 9133293178 Enrollment ID: I20080808000395 |
| Provider Name | Imad Uddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245498906 PECOS PAC ID: 3870764285 Enrollment ID: I20110915000274 |
| Provider Name | Vishal Mundra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235469503 PECOS PAC ID: 0749453926 Enrollment ID: I20111103000448 |
| Provider Name | Shannon G Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477838217 PECOS PAC ID: 1658546759 Enrollment ID: I20111219000098 |
| Provider Name | Pavankumar Bommasamudram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639306293 PECOS PAC ID: 3779749478 Enrollment ID: I20120725000093 |
| Provider Name | Stephen Mikus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598086050 PECOS PAC ID: 7719121938 Enrollment ID: I20130910000128 |
| Provider Name | Monica Tubbesing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063876985 PECOS PAC ID: 0446532428 Enrollment ID: I20170127000397 |
| Provider Name | Audrianna Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245766294 PECOS PAC ID: 1355615626 Enrollment ID: I20170926000549 |
| Provider Name | Jessica Susan Culpepper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033766167 PECOS PAC ID: 3870926363 Enrollment ID: I20191216000559 |
| Provider Name | Cassy Ranae Morse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396353439 PECOS PAC ID: 0840607776 Enrollment ID: I20210322000397 |
| Provider Name | Mark Borsody |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215179767 PECOS PAC ID: 5890844575 Enrollment ID: I20230123000220 |
| Provider Name | Dolly B Roy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053469072 PECOS PAC ID: 9436245891 Enrollment ID: I20230313000038 |
| Provider Name | Alvin Wong |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1639738602 PECOS PAC ID: 2466811120 Enrollment ID: I20230629000533 |
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