Phillip Wayne Halcum, M.D.

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

C-7091 Issued in AR

Practice address

109 Kerr Ave
Poteau, OK 74953-5270

Phone

(918) 649-1100

Fax

(918) 649-1199

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1013972884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8625 COVE CIR",
            "city": "HACKETT",
            "state": "AR",
            "postal_code": "729374161",
            "telephone_number": "501-690-0298",
            "fax_number": "918-649-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 KERR AVE",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749535270",
            "telephone_number": "918-649-1100",
            "fax_number": "918-649-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALCUM",
        "first_name": "PHILLIP",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "AR",
            "license": "C-7091",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NM",
            "license": "91-62",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Groves
• Brandi Grubbs, LPTA
• GTZ and Enk
• Jeanne R Guinn, APRN
• Lindsey A Hackney, PTA
• Breanna Hall
• Jessica Lois Hall, PA
• Loralee Anice Hamman, BSN, RN, SNM
• Heather Lynn Hammons, BHRS
• Kandace Handy

• Military Health Care Provider in Poteau, OK
• Providers in Poteau, OK by specialty
• Military Health Care Provider in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.