Ryan A Pitts (NPI# 1356314603, PAC ID# 0941225023) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1356314603 |
PAC ID by PECOS | 0941225023 |
Professional Enrollment ID | I20051129000241 |
Full Name | Ryan A Pitts |
Organization Legal Name | CLINIC AT WELLSTON |
Address |
309 E 2nd St Suite B Wellston OK 74881-9496 |
Phone Number | 4053563035 |
Gender | M |
Credential | DO |
Medical School | CHICAGO COLLEGE OF OSTEOPATHIC MEDICINE |
Graduation Year | 2001 |
Primary Specialty | FAMILY MEDICINE |
Secondary Specialties | SPORTS MEDICINE |
Group Practice PAC ID | 2668739467 |
Number of Group Practice Members | 2 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
371337 | EASTERN OKLAHOMA MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
500 S Broadway St, Suite D, Poteau, OK 74953-3819 | 9185642270 | TOTAL HEALTH SOLUTIONS LLC |
309 E 2nd St, Suite B, Wellston, OK 74881-9496 | 4053563035 | CLINIC AT WELLSTON |
Organization Legal Name | CLINIC AT WELLSTON |
Physicians | 3 |
Name | Specialty | Organization | Address |
---|---|---|---|
John D Grizzle Ii | Family Medicine | Clinic At Wellston | 309 E 2nd St, Suite B, Wellston, OK 74881-9496 |
Katie J.e. Pankowsky | Nurse Practitioner | Clinic At Wellston | 309 E 2nd St, Suite B, Wellston, OK 74881-9496 |
Street Address |
309 E 2ND ST SUITE B |
City | WELLSTON |
State | OK |
Zip | 74881-9496 |
Name | Specialty | Organization | Address |
---|---|---|---|
John D Grizzle Ii | Family Medicine | Clinic At Wellston | 309 E 2nd St, Suite B, Wellston, OK 74881-9496 |
Katie J.e. Pankowsky | Nurse Practitioner | Clinic At Wellston | 309 E 2nd St, Suite B, Wellston, OK 74881-9496 |
Name | Specialty | Organization | Address |
---|---|---|---|
Yombi Melanie Ngouanyo Taponno | Nurse Practitioner | Best Physicians At Home, Inc | 315 W 2nd St, Wellston, OK 74881-9496 |
Katie M Rodgers | Nurse Practitioner | Clinton J Baird Plc | 309 W 2nd St, Olympia Neurological Institute, Wellston, OK 74881-9496 |
James M Ferris | Family Practice | Best Physicians At Home, Inc | 312 E 2nd St, Wellston, OK 74881-9496 |
City | WELLSTON |
Zip Code | 74881 |
Specialty | FAMILY MEDICINE |
City + Specialty | WELLSTON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Ryan A Pitts.
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.