Pamela E Ahearn, MD
Individual provider Active NPI Family Medicine Physician · Kingston, OK
NPI 1780684357 · NPPES record last updated Jul 13, 2018
Key facts
- NPI
- 1780684357
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 19862 (OK)
- Practice address
- 714 Highway 70 E
Kingston, OK 73439 - Phone
- (580) 564-0200
- Fax
- (580) 564-0201
- NPI assigned
- Jul 26, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100303000612 | OK | Practitioner - Family Practice |
6305981218 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oklahoma Emergency Physician Partners PLLC | Current | Accepting new patients | |
| Baptist Healthcare of Oklahoma, Inc | Past | Accepting new patients | |
| Baptist Healthcare of Oklahoma Inc | Past | Accepting new patients | |
| Marshall County HMPN, LLC | Family Medicine | Past | Accepting new patients |
| Marshall County Hma LLC | Family Medicine | Past | Accepting new patients |
Locations
1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | L2077 | TX | |
| Family Medicine Physician | 207Q00000X | 19862 | OK | Yes |
Addresses
Primary practice location
714 Highway 70 E
Kingston, OK 73439
Mailing address
5012 US Hwy 75 S, Suite 300
Att: Billing
Denison, TX 75020
Phone (580) 920-2273
Other practice location 1
3126 W Fm 120
Denison, TX 75020-1249
Phone (903) 416-7544
Other practice location 2
1807 W University Blvd
Durant, OK 74701-3011
Phone (580) 920-2273
Other practice location 3
2 Hospital Dr
Madill, OK 73446
Phone (580) 795-0191
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100102140B | Medicaid | OK |
Other names
- Pamela E Delashaw
Other providers in Kingston, OK
- A Path of Care Home Health V, LLC
- Charles Robert Anderson
- Kartika Rasberry Anderson
- Lexie Darlene Avery
- Ayandeh Health LLC
- Bagwell Family Medicine P.L.L.C.
All providers in Kingston, OK · Family Medicine 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 13, 2018. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.