Brad A Liston (NPI# 1487817375, PAC ID# 4183780729) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1487817375 |
| PAC ID by PECOS | 4183780729 |
| Professional Enrollment ID | I20090305000276 |
| Full Name | Brad A Liston |
| Organization Legal Name | KAY COUNTY CLINIC COMPANY LLC |
| Address |
1900 N 14th St Ponca City OK 74601-2035 |
| Phone Number | 5807182932 |
| Gender | M |
| Graduation Year | 2007 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 8921006784 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370006 | PONCA CITY MEDICAL CENTER |
| 370049 | STILLWATER MEDICAL CENTER |
| 370093 | OU MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1900 N 14th St, Ponca City, OK 74601-2035 | 5807182932 | KAY COUNTY CLINIC COMPANY LLC |
| 1908 N 14th St, Ponca City, OK 74601-2039 | KAY COUNTY CLINIC COMPANY LLC |
| Organization Legal Name | KAY COUNTY CLINIC COMPANY LLC |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary Janelle Murray | Nurse Practitioner | Kay County Clinic Company LLC | 1715 N 5th St, Ponca City, OK 74601-2763 |
| Aaron P Wilcox | Family Medicine | Kay County Clinic Company LLC | 415 Fairview Ave, Suite 201, Ponca City, OK 74601-1932 |
| Timothy B Gilbert | General Surgery | Kay County Clinic Company LLC | 121 Patton Dr, Ponca City, OK 74601-2030 |
| William M Slater | General Surgery | Kay County Clinic Company LLC | 1900 N 14th St, Ponca City, OK 74601-2035 |
| Paul B Plowman | Obstetrics/gynecology | Kay County Clinic Company LLC | 1900 N 14th St, Ponca City, OK 74601-2035 |
| Rhonda Green | Family Medicine | Kay County Clinic Company LLC | 415 Fairview Ave, Suite 201, Ponca City, OK 74601-1932 |
| David M Sparks | Orthopedic Surgery | Kay County Clinic Company LLC | 415 Fairview Ave, Suite 201, Ponca City, OK 74601-1932 |
| Eva Case | Nurse Practitioner | Kay County Clinic Company LLC | 1908 N 14th St, Suite 202, Ponca City, OK 74601-2039 |
| David A Schmeidler | Family Medicine | Kay County Clinic Company LLC | 510 W Radio Ln, Arkansas City, KS 67005-4011 |
| Tracy S Ogden | Nurse Practitioner | Kay County Clinic Company LLC | 1900 N 14th St, Ponca City, OK 74601-2035 |
| Street Address |
1900 N 14TH ST |
| City | PONCA CITY |
| State | OK |
| Zip | 74601-2035 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rodney D Mann | Certified Registered Nurse Anesthetist (crna) | Clinical Colleagues Inc | 1900 N 14th St, Ponca City, OK 74601-2035 |
| Charles M Fofang | Nurse Practitioner | Nes Oklahoma, Inc. | 1900 N 14th St, Alliancehealth Ponca City Er Department, Ponca City, OK 74601-2035 |
| Bruce Baugher | Internal Medicine | Nes Oklahoma, Inc. | 1900 N 14th St, Alliancehealth Ponca City Er Department, Ponca City, OK 74601-2035 |
| Ryan David Myers | Emergency Medicine | Nes Oklahoma, Inc. | 1900 N 14th St, Alliancehealth Ponca City Er Department, Ponca City, OK 74601-2035 |
| William M Slater | General Surgery | Kay County Clinic Company LLC | 1900 N 14th St, Ponca City, OK 74601-2035 |
| Ron M Kreger | Obstetrics/gynecology | 1900 N 14th St, Ponca City, OK 74601-2035 | |
| Demille W Madoux | Emergency Medicine | Nes Oklahoma, Inc. | 1900 N 14th St, Alliancehealth Ponca City Er Department, Ponca City, OK 74601-2035 |
| Hafida R Mumallah | Family Medicine | Nes Oklahoma, Inc. | 1900 N 14th St, Alliancehealth Ponca City Er Department, Ponca City, OK 74601-2035 |
| Brady Reed | Certified Registered Nurse Anesthetist (crna) | Clinical Colleagues Inc | 1900 N 14th St, Ponca City, OK 74601-2035 |
| Scott P Turner | Internal Medicine | Nes Oklahoma, Inc. | 1900 N 14th St, Alliancehealth Ponca City Er Department, Ponca City, OK 74601-2035 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelsey Blaine Burnett | Physician Assistant | Amc Urgent Care Plus LLC | 2101 N 14th St, Suite 114, Ponca City, OK 74601-1807 |
| Codi N Vilhauer | Physician Assistant | Amc Urgent Care Plus LLC | 2101 N 14th St, Suite 114, Ponca City, OK 74601-1807 |
| Judy Nielsen | Physician Assistant | Amc Urgent Care Plus LLC | 2101 N 14th St, Suite 114, Ponca City, OK 74601-1807 |
| Thomas M Carter | Ophthalmology | 400 Fairview Ave, Suite 21, Ponca City, OK 74601-1910 | |
| Mark Edward Rigney | Family Medicine | 400 Fairview, Bldg 3 Suite 20, Ponca City, OK 74601-1910 | |
| Phillip J Knight | Family Medicine | 400 Fairview Ave, Suite 15, Ponca City, OK 74601-1910 | |
| Michael S Schiff | Cardiovascular Disease (cardiology) | Integris Cardiovascular Physicians LLC | 400 Fairview Ave, Suite 19, Ponca City, OK 74601-1910 |
| William R Howard | Otolaryngology | 400 Fairview Ave, Suite 16, Ponca City, OK 74601-1910 | |
| Gary A Dorman | Optometry | 400 Fairview Ave, Suite 21, Ponca City, OK 74601-1910 | |
| Shrikrishna V Vaidya | Neurology | 400 Fairview Ave, Ponca City, OK 74601-1910 | |
| Find all physicians in zip 74601 | |||
| City | PONCA CITY |
| Zip Code | 74601 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PONCA CITY + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Brad A Liston.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.