Blake Middleton (NPI# 1568703700, PAC ID# 6709006554) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1568703700 |
| PAC ID by PECOS | 6709006554 |
| Professional Enrollment ID | I20140930001902 |
| Full Name | Blake Middleton |
| Organization Legal Name | MCBRIDE CLINIC ORTHOPEDIC HOSPITAL, LLC |
| Address |
3406 S Boulevard Edmond OK 73013-5481 |
| Phone Number | 4052309700 |
| Gender | M |
| Medical School | OKLAHOMA COLLEGE OF OSTEOPATHIC MEDICINE AND SURGERY |
| Graduation Year | 2013 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | SPORTS MEDICINE |
| Group Practice PAC ID | 3678514809 |
| Number of Group Practice Members | 63 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370222 | MCBRIDE ORTHOPEDIC HOSPITAL |
| 370013 | MERCY HOSPITAL OKLAHOMA CITY, INC |
| 370093 | OU MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3406 S Boulevard, Edmond, OK 73013-5481 | 4052309700 | MCBRIDE CLINIC ORTHOPEDIC HOSPITAL, LLC |
| 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 4054862100 | MCBRIDE CLINIC ORTHOPEDIC HOSPITAL, LLC |
| Organization Legal Name | MCBRIDE CLINIC ORTHOPEDIC HOSPITAL, LLC |
| Physicians | 72 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark C Shreve | Hand Surgery | Mcbride Clinic Orthopedic Hospital, LLC | 400 N Bryant Ave, Edmond, OK 73034-3206 |
| David E Ruhl | Physical Therapy | Mcbride Clinic Orthopedic Hospital, LLC | 815 Nw 12th St, Oklahoma City, OK 73103-6802 |
| Sidonie R Bevier | Physical Therapy | Mcbride Clinic Orthopedic Hospital, LLC | 3700 36th Ave Nw, Norman, OK 73072-1803 |
| Ryan M Ballard | Physician Assistant | Mcbride Clinic Orthopedic Hospital, LLC | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 |
| Amber D Haynes | Physician Assistant | Mcbride Clinic Orthopedic Hospital, LLC | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 |
| Aaron C Wade | Physician Assistant | Mcbride Clinic Orthopedic Hospital, LLC | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 |
| Thomas Tkach | Orthopedic Surgery | Mcbride Clinic Orthopedic Hospital, LLC | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 |
| Deborah S Mason | Physical Therapy | Mcbride Clinic Orthopedic Hospital, LLC | 3700 36th Ave Nw, Norman, OK 73072-1803 |
| Benjamin I Panter | Orthopedic Surgery | Mcbride Clinic Orthopedic Hospital, LLC | 3700 36th Ave Nw, Norman, OK 73072-1803 |
| April J Johnson | Nurse Practitioner | Mcbride Clinic Orthopedic Hospital, LLC | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 |
| Street Address |
3406 S BOULEVARD |
| City | EDMOND |
| State | OK |
| Zip | 73013-5481 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gary Schick | Physical Medicine and Rehabilitation | Mcbride Clinic Orthopedic Hospital, LLC | 3406 S Boulevard, Edmond, OK 73013-5481 |
| Danny D Williams | Physician Assistant | Mcbride Clinic Orthopedic Hospital, LLC | 3406 S Boulevard, Edmond, OK 73013-5481 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Senthil K Raju | Family Medicine | 11824 Slash Pine Dr, Edmond, OK 73013-0462 | |
| Dinah S Cloud | Psychologist, Clinical | 929 Nw 164th St, Suite 111, Edmond, OK 73013-1002 | |
| Lori A Fredrick | Diagnostic Radiology | Board of Regents of The University of Oklahoma - Ou Physicians | 14101 N Eastern Ave, Ou Physicians At Edmond, Edmond, OK 73013-1039 |
| Joseph Davey | Orthopedic Surgery | Board of Regents of The University of Oklahoma - Ou Physicians | 14101 N Eastern Ave, Ou Physicians At Edmond, Edmond, OK 73013-1039 |
| Sara Kathleen Watson | Family Medicine | Board of Regents of The University of Oklahoma - Ou Physicians | 14101 N Eastern Ave, Ou Physicians At Edmond, Edmond, OK 73013-1039 |
| Neadum B Odum | Chiropractic | 15100 Traditions Blvd, Suite 1, Edmond, OK 73013-1184 | |
| Ashley D Mathias | Nurse Practitioner | James Avery Rush Iv Md Pa | 15205 Traditions Lake Pkwy, Edmond, OK 73013-1198 |
| Tanya M Rennie | Nurse Practitioner | James Avery Rush Iv Md Pa | 15205 Traditions Lake Pkwy, Edmond, OK 73013-1198 |
| Michael Daniel Spieker | Nurse Practitioner | James Avery Rush Iv Md Pa | 15205 Traditions Lake Pkwy, Edmond, OK 73013-1198 |
| Amer B Nouh | Neurology | 1417 Nw 150th St, Neuro Pain Care, Edmond, OK 73013-1305 | |
| Find all physicians in zip 73013 | |||
| City | EDMOND |
| Zip Code | 73013 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | EDMOND + FAMILY MEDICINE |
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| 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.