Andrew R Olshen (NPI# 1386663532, PAC ID# 8224923404) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1386663532 |
| PAC ID by PECOS | 8224923404 |
| Professional Enrollment ID | I20040219000816 |
| Full Name | Andrew R Olshen |
| 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 | MD |
| Medical School | UMDNJ-ROBERT WOOD JOHNSON MEDICAL SCHOOL |
| Graduation Year | 1994 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 4082861349 |
| Number of Group Practice Members | 33 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370089 | NORTHEASTERN HEALTH SYSTEM |
| 370025 | SAINT FRANCIS HOSPITAL MUSKOGEE |
| 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 |
| Organization Legal Name | TAHLEQUAH MEDICAL GROUP LLC |
| Physicians | 10 |
| 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 |
| Steven A Smith | Dermatology | Tahlequah Medical Group LLC | 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001 |
| Charles R Mutch | Physician Assistant | 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 |
| Street Address |
104 LONE OAK CIRCLE FT GIBSON MEDICAL |
| City | FT GIBSON |
| State | OK |
| Zip | 74434-5001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa Renfrow | Nurse Practitioner | 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 |
| Charles R Mutch | Physician Assistant | Tahlequah Medical Group LLC | 104 Lone Oak Circle, Ft Gibson Medical, Ft Gibson, OK 74434-5001 |
| 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 |
| City | FT GIBSON |
| Zip Code | 74434 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | FT GIBSON + PHYSICAL MEDICINE AND REHABILITATION |
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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.