Digestive Disease Specialists Inc
Organization Active NPI Gastroenterology Physician · Oklahoma City, OK
NPI 1366489213 · NPPES record last updated Jul 11, 2007
Key facts
- NPI
- 1366489213
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- Legal business name
- DIGESTIVE DISEASE SPECIALISTS INC
- Practice address
- 5015 N Pennsylvania Ave
Ste. 303
Oklahoma City, OK 73112-8891 - Phone
- (405) 767-6630
- Fax
- (405) 767-1176
- NPI assigned
- Jun 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Bill R. Davis
- Title
- Administrator
- Phone
- (405) 767-6630
Member organizations 3
Practitioners 49
-
Neil Edward Crittenden, M.D.
-
Ross Stanford Keener, M.D.
-
Son Nguyen, M.D.
-
Salman Nusrat, M.D.
-
Kieuhan Theresa Pham, PA-C
-
Carl Andrew Raczkowski, M.D.
-
Scottie Lynn Smith, APRN
-
Zachary Daniel Smith, M.D.
-
Verapan Vongthavaravat, M.D.
-
Sumit A Walia, MD
-
Maria Corazon Chang, M.D.
-
Pramoda Koduru, M.D
-
Robin Edward Cook, CRNA
-
Libu Kurian, RN
-
Lauren Huber Le, CRNA
-
Chaz White, CRNA
-
Nicole Jeanne Alvarez, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040331001151 | OK | Part B Supplier - Clinic/Group Practice | 7315939279 |
Receives reassigned benefits from 44 practitioners Practice locations: Oklahoma City, OK |
National Provider Directory
Locations
3400 W Tecumseh Rd
Ste 100
Norman, OK 73072
Phone (405) 307-6900
8121 National Ave
Ste 330
Oklahoma City, OK 73110
8121 National Ave
Ste 303
Oklahoma City, OK 73110
Phone (405) 737-4464
701 Cedar Lake Blvd
Ste 301
Oklahoma City, OK 73114
3366 NW Expressway St
Ste 400
Oklahoma City, OK 73112
Phone (405) 702-1300
3366 N West Expy
Ste 400D
Oklahoma City, OK 73112
1205 Health Center Pkwy
Ste 220
Yukon, OK 73099
Phone (405) 717-5490
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | Yes |
Addresses
Primary practice location
5015 N Pennsylvania Ave
Ste. 303
Oklahoma City, OK 73112-8891
Mailing address
PO Box 7316
Edmond, OK 73083-7316
Phone (405) 767-6630
Other providers in Oklahoma City, OK
- Vincent M Dieu
- Luis Enrique Diez Avila
- Leah Digby
- Digestive Disease Pathology LLC
- Digestive Disease Specialists Inc
- Alexei Renee Danielle Diggs
- Da'Jon Shalae Diggs
- John Robert Digiovanni II
- Danielle Digoy
- German Paul Digoy
All providers in Oklahoma City, OK · Gastroenterology Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.