DR. PHILLIP WAYNE HALCUM (NPI# 1013972884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013972884 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP WAYNE HALCUM |
| Credential | M.D. |
| Practice Address |
109 Kerr Ave Poteau OK 74953-5270 |
| Mailing Address |
8625 Cove Cir Hackett AR 72937-4161 |
| Practice Telephone | 9186491100 |
| Practice Fax Number | 9186491199 |
| Mailing Telephone | 5016900298 |
| Mailing Fax Number | 9186491199 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2011-07-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171000000X | Military Health Care Provider | 91-62 | NM | Other Service Providers |
| Y | 171000000X | Military Health Care Provider | C-7091 | AR | Other Service Providers |
| Street Address |
109 KERR AVE |
| City | POTEAU |
| State | OK |
| Zip Code | 74953-5270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134105059 | Frank Jay Smith | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2005-12-22 |
| 1134690944 | Crystal D Hensley | Registered Nurse | 109 Kerr Ave, Poteau, OK 74953-5270 | 2018-12-06 |
| 1174004139 | Alex Nevitt | Physical Therapist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2018-08-27 |
| 1780136705 | Choctaw Nation Health Services Authority | Clinic/Center | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-10-25 |
| 1316493380 | Megan Schmidt | Pharmacist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-08-30 |
| 1669838983 | Michelle Rene Dawson | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-01-04 |
| 1578938064 | Jammie Owens | Pharmacist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2015-12-09 |
| 1457734063 | Jennifer Dillard | Optometrist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2015-06-30 |
| 1063847556 | Stefanie Janine Terrell | Pharmacist | 109 Kerr Ave, Poteau, OK 74953 | 2013-09-04 |
| 1841549318 | Jessica Lois Hall | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235644550 | Kim Lynn Mcconnell | Case Manager/Care Coordinator | 907 Grace St., Poteau, OK 74953 | 2017-12-08 |
| 1356889745 | Brenda Stacy | Prevention Professional | 507 Drwey, Potesu, OK 74953 | 2017-02-06 |
| 1639621451 | Sabrina Danielle Minor | Case Manager/Care Coordinator | 15715 Greentop Road, Poteau, OK 74953 | 2016-10-27 |
| 1902352545 | Daniel Jesse Bruesch | Counselor | 600 Oklahoma Ave., Poteau, OK 74953 | 2016-09-01 |
| 1578912465 | Jo Ann Walden | Counselor | 507 Dewey Avenue, Poteau, OK 74953 | 2016-06-10 |
| 1154708477 | Kendal Repass | Specialist/Technologist | 17100 Nail Creek, Poteau, OK 74953 | 2015-05-06 |
| 1669891768 | Jennifer Branscum | Case Manager/Care Coordinator | 22681 Valley View Rd, Poteau, OK 74953 | 2014-04-16 |
| 1437582145 | Kim Loggains | Counselor | 2104 A-n. Broadway, Poteau, OK 74953 | 2013-08-16 |
| 1457783573 | Derek Morris | Counselor | 3111b N. Broadway St., Box 34, Poteau, OK 74953 | 2013-07-31 |
| 1568743177 | Carol Ann Oliver | Counselor | 34183 Country Club Lane, Poteau, OK 74953 | 2011-09-09 |
| Find all providers in zip 74953 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225527476 | Pau Khan Kap | Military Health Care Provider | 10123 S 72nd East Ave, Tulsa, OK 74133-6759 | 2018-05-03 |
| 1336556851 | Chenghui Su | Military Health Care Provider | 463 N Harr Dr Apt F, Midwest City, OK 73110-2922 | 2014-07-16 |
| 1245506500 | Sharon Lynne Rogers | Military Health Care Provider | 3415 Minor Rd, Fort Sill, OK 73503-4460 | 2012-03-30 |
| 1831216852 | Lois Ann Umdenstock | Military Health Care Provider | 6136 S Fulton Ave, Tulsa, OK 74136-2007 | 2007-03-23 |
| 1881788834 | Us Army | Military Health Care Provider | 42 Ne Pheasant Ln, Lawton, OK 73507-8850 | 2006-10-03 |
| 1225598980 | Andrew Jonathan Carey | Military Health Care Provider | 527 Gott Rd, Enid, OK 73705-5103 | 2019-03-20 |
| 1801024369 | John Allan Miller | Military Health Care Provider | 3009 Nw Wilson St, Ft. Sill, OK 73503-9042 | 2009-06-23 |
| 1871527929 | Vinh X Vu | Military Health Care Provider | 5700 Arnold St, Tinker Afb, OK 73145-8105 | 2006-07-11 |
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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.