Charles R Mutch
TAHLEQUAH MEDICAL GROUP LLC


Address: 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001
Phone: 9184782101

Charles R Mutch (NPI# 1831206671, PAC ID# 7214987114) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.

Physician Overview

Nation Provider ID (NPI) 1831206671
PAC ID by PECOS 7214987114
Professional Enrollment ID I20050319000003
Full Name Charles R Mutch
Organization Legal Name TAHLEQUAH MEDICAL GROUP LLC
Address 104 Lone Oak Circle
Ft Gibson Medical
Ft Gibson
OK 74434-5001
Phone Number 9184782101
Gender M
Credential PA
Graduation Year 1972
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 4082861349
Number of Group Practice Members 33
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
370089 NORTHEASTERN HEALTH SYSTEM

Other Locations

Address Phone Organization
104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001 9184782101 TAHLEQUAH MEDICAL GROUP LLC
1400 E Downing, Tahlequah City Hospital, Tahleqhah, OK 74464-3324 9184560641 TAHLEQUAH MEDICAL GROUP LLC

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %

Organization Information

Organization Legal Name TAHLEQUAH MEDICAL GROUP LLC
Physicians 10

Physicians with the same organization

Name Specialty Organization Address
Lisa Renfrow Nurse Practitioner Tahlequah Medical Group LLC 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001
Deanna Wright Nurse Practitioner Tahlequah Medical Group LLC 1373 E Boone Street, Suite 2300, Tahlequah, OK 74464-3330
Paul Hobbs Internal Medicine Tahlequah Medical Group LLC 1400 E Downing, Tahlequah City Hospital, Tahleqhah, OK 74464-3324
Robert D Hensley Psychiatry Tahlequah Medical Group LLC 1201 E Ross Bypass, Tahlequah, OK 74464-4188
Andrew R Olshen Physical Medicine and Rehabilitation Tahlequah Medical Group LLC 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001
Steven A Smith Dermatology Tahlequah Medical Group LLC 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001
Teresa Nabors Nurse Practitioner Tahlequah Medical Group LLC 1400 E Downing, Tahlequah City Hospital, Tahleqhah, OK 74464-3324
Janet L Plaxico Physician Assistant Tahlequah Medical Group LLC 1400 E Downing, Tahlequah City Hospital, Tahleqhah, OK 74464-3324
Coy J Edwards Family Practice Tahlequah Medical Group LLC 1400 E Downing, Tahlequah City Hospital, Tahleqhah, OK 74464-3324

Office Location

Street Address 104 LONE OAK CIRCLE
FT GIBSON MEDICAL
City FT GIBSON
State OK
Zip 74434-5001

Physicians in the same location

Name Specialty Organization Address
Lisa Renfrow Nurse Practitioner Tahlequah Medical Group LLC 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001
Andrew R Olshen Physical Medicine and Rehabilitation Tahlequah Medical Group LLC 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001
Steven A Smith Dermatology Tahlequah Medical Group LLC 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001

Physicians in the same zip code

Name Specialty Organization Address
Charity Dawn Johnson Family Medicine Warren Clinic Inc 108 Lone Oak Cir, Fort Gibson, OK 74434-5001
Garry T Page Jr. Chiropractic 1596 S Lee St, Fort Gibson, OK 74434-8403
Ann Elizabeth Page Chiropractic 1596 S Lee St, Fort Gibson, OK 74434-8403
Debbie S Coy Optometry 330 W Hwy 62, Fort Gibson, OK 74434-8446
Kelly E Glass Optometry Debbie S. Coy, O.d. P.C. 330 W Hwy 62, Fort Gibson, OK 74434-8446
Dennis H Garrison Optometry 799 S Lee St, Fort Gibson, OK 74434-8708

Competitor

Search similar physicians

City FT GIBSON
Zip Code 74434
Specialty PHYSICIAN ASSISTANT
City + Specialty FT GIBSON + PHYSICIAN ASSISTANT

Improve Information

Please comment or provide details below to improve the information on Charles R Mutch.

Dataset Information

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.

Trending Searches