Individual provider Active NPI

Aldon Elisworth Corle Jr., MD

  • Obstetrics & Gynecology Physician
  • Bartlesville, OK
National Provider Identifier
1639396583
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
30202 Issued in OK
Practice address
3400 E Frank Phillips Blvd
Bartlesville, OK 74006-2495
Phone
(918) 331-2533
Fax
(918) 331-2539
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 30202 OK Primary

Addresses

Primary practice location

3400 E Frank Phillips Blvd
Bartlesville, OK 74006-2495

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2630

Other identifiers 1

IdentifierTypeStateIssuer
200502110AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131028001453 OK Practitioner - Obstetrics/Gynecology 8628101219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Kansas School of Med (KC/Wich/Sal), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

3550 E Frank Phillips Blvd
Bartlesville, OK 74006-2411
Phone (918) 331-2294

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Oklahoma Community Health Centers, Inc CurrentSince Nov 1, 2020 Accepting new patients
St. John Physicians, Inc. Obstetrics & Gynecology CurrentSince Dec 27, 2022 Accepting new patients
Northeastern Oklahoma Community Health Centers Inc Current Accepting new patients
St. John Physicians, Inc CurrentSince Dec 27, 2022 Accepting new patients
Northeastern Oklahoma Community Health Centers Inc CurrentSince Nov 1, 2020 Accepting new patients
Jane Phillips Memorial Medical Center, Inc. Past Accepting new patients
Mid-Kansas Women's Center P.a. Obstetrics & Gynecology Past Accepting new patients

Locations

3400 E Frank Phillips Blvd
Ste 501
Bartlesville, OK 74006
Phone (918) 331-2415

3400 E Frank Phillips Blvd
Bartlesville, OK 74006
Phone (918) 331-2441

3400 E Frank Phillips Blvd
Ste 400
Bartlesville, OK 74006
Phone (918) 331-2522

124 E Main St
Hulbert, OK 74441
Phone (918) 772-2879

1500 E Downing St
Ste 201
Tahlequah, OK 74464
Phone (918) 772-3390

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1639396583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-2630",
            "fax_number": "918-744-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E FRANK PHILLIPS BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062495",
            "telephone_number": "918-331-2533",
            "fax_number": "918-331-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLE",
        "first_name": "ALDON",
        "middle_name": "ELISWORTH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "30202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200502110A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.