MATTHEW BLAKE WEDMAN (NPI# 1306106729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306106729 |
| Entity Type | Individual |
| Full Name | MATTHEW BLAKE WEDMAN |
| Credential | MD |
| Practice Address |
14201 Sw 15th St Yukon OK 73099 |
| Mailing Address |
Po Box 2690, Garrison Tower, Suite 4g4250 Oklahoma City OK 73126 |
| Practice Telephone | 4058337290 |
| Mailing Telephone | 4052718001 |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2018-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
29866 | OK | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | BP10043387 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
14201 SW 15TH ST |
| City | YUKON |
| State | OK |
| Zip Code | 73099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922625201 | Bintu Sinju Thomas | Nurse Practitioner | 752 Dana Dr Yukon Oklahoma, Yukon, OK 73099 | 2020-07-02 |
| 1164049185 | Custom Dental of Yukon, Pllc | Clinic/Center | 4425 Grant Blvd, Yukon, OK 73099 | 2020-06-26 |
| 1720600174 | Piedmont Dentistry & Braces | Clinic/Center | 12000 Nw Expressway, Yukon, OK 73099 | 2020-05-08 |
| 1073135588 | Yukon Dentistry & Braces | Clinic/Center | 901 E Main Street, Suite 100, Yukon, OK 73099 | 2020-05-07 |
| 1457998734 | Here At Home Senior Care LLC | In Home Supportive Care | 7709 Nw Expressway Ste B, Yukon, OK 73099 | 2019-12-05 |
| 1255981619 | Mariam Reynolds | Case Manager/Care Coordinator | 7905 Ok-66, El Reno, OK 73099 | 2019-09-18 |
| 1780239202 | Immediate Care of Oklahoma, LLC | Clinic/Center | 10616 U.S. Highway 66, Suite 100, Oklahoma City, OK 73099 | 2019-08-02 |
| 1013490689 | Jade Bell | Physical Therapy Assistant | 1000 Desert Trail, Yukon, OK 73099 | 2018-09-10 |
| 1821570250 | Anjoli Tamesha Vanwey | Case Manager/Care Coordinator | 1213 Yuhoma Dr, Yukon, OK 73099 | 2018-09-01 |
| 1194220780 | Michael Lee Lefever | Case Manager/Care Coordinator | 11705 Sw 115th Ter, Yukon, OK 73099 | 2018-03-27 |
| Find all providers in zip 73099 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104442292 | Direct Medical Imaging LLC | Radiology | 5711 E 71st St Ste 100, Tulsa, OK 74136-6655 | 2020-06-24 |
| 1225594583 | Texas Sonography Associates, LLC | Radiology | 213 E Main St Ste 400, Calera, OK 74730-2115 | 2019-02-12 |
| 1336689298 | Rose Gideon | Radiology | 3904 Hidden Hill Rd, Norman, OK 73072-3006 | 2017-02-26 |
| 1972962876 | Christine Loeffler | Radiology | 44493 State Highway 9, Tecumseh, OK 74873-0113 | 2016-02-19 |
| 1760829220 | Derrick Durell Wagoner | Radiology | 1800 Renaissance Blvd Ste 110, Edmond, OK 73013 | 2013-05-23 |
| 1275887663 | Donald Von Borstel | Radiology | 12533 E 83rd St N, Owasso, OK 74055-6234 | 2012-11-06 |
| 1952662363 | Julia Dry Knarreborg | Radiology | 1817 Rocky Mountain Way, Edmond, OK 73003-4640 | 2012-06-01 |
| 1346508041 | Telerad of Ok Account Management, LLC | Radiology | 4608 Briar Meade Rd, Edmond, OK 73025-9222 | 2012-05-01 |
| 1053601237 | Anjali Lal | Radiology | 940 Ne 13th St Ste 4g4250, Oklahoma City, OK 73104 | 2011-04-08 |
| 1386933737 | Robert A Skib Md Pllc | Radiology | 305 S Kenosha Ave, Tulsa, OK 74120-2430 | 2011-04-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.