Mr. Robert Luther Waddell
Surgery

Address: 435 N Monte Vista, Ada, OK 74820
Phone: 5803100102

Mr. Robert Luther Waddell (NPI# 1750485058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1750485058
Entity Type Individual
Full Name Mr. Robert Luther Waddell
Credential MD
Gender Male
Practice Address 435 N Monte Vista
Ada
OK 74820
Practice Telephone 5803100102
Practice Fax Number 5803100104
Mailing Address 530 N Monte Vista St
Suite A
Ada
OK 74820-4675
Mailing Telephone 5804367101
Mailing Fax Number 5804364447
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-09-08
Last Update Date 2014-10-27

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 208600000X Surgery Allopathic & Osteopathic Physicians 20345 OK

Other Provider Identifier

State Identifier Issuer Type Code
OK 10015510A MEDICAID

Other Providers ROBERT WADDELL

NPI Name Taxonomy Address Enumeration
1922167329 Robert Donald Waddell Jr. Chiropractor 12099 Lake Blvd, Lindstrom, MN 55045 2006-12-08
1033445218 Robert Donald Waddell IIi Chiropractor 12099 Lake Blvd, Lindstrom, MN 55045-9322 2009-10-23

Physician Overview

NPI 1750485058
PAC ID by PECOS 9931386083
Professional Enrollment ID I20110527000145
Full Name Robert L Waddell
Organization Legal Name MERCY CLINIC OKLAHOMA COMMUNITIES
Phone Number 4057551515
Gender M
Medical School UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduation Year 1974
Primary Specialty GENERAL SURGERY
Group Practice PAC ID 1153468921
Number of Group Practice Members 417
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
370020 MERCY HOSPITAL ADA

Office Location

Street Address 435 N MONTE VISTA
City ADA
State OK
Zip Code 74820

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063988673 Central Oklahoma Family Medical Center, Inc Clinic/Center 905 Colony Drive Bldg, Ada, OK 74820 2018-10-22
1265907885 Apex Surgery Center, LLC Surgery 2001 Cradduck Road, Ada, OK 74820 2018-10-10
1689150898 Sabrina Simmons Social Worker 2516 Oakhurst Dr Apt E, Ada, OK 74820 2018-07-11
1457858813 Lea Caufield Health Educator Diabetes Care Center - Chickasaw Nation Medical Center, 1921 Stonecipher Blvd, Ada, OK 74820 2018-04-11
1841790995 Charles Edward Moore II Case Manager/Care Coordinator 2024 Te Ata Drive, Ada, OK 74820 2018-02-15
1104325844 Leah Rachel Miller Dietitian, Registered Mercy Hospital Ada - Food and Nutrition Services, 430 N Monte Vista, Ada, OK 74820 2018-02-08
1033637616 Samantha Monique Gonzalez Case Manager/Care Coordinator 111 E St 12th, Ada, OK 74820 2017-09-05
1851814156 Carol Ruth Solesbee Acupuncturist 7240 Cr 1525, Ada, OK 74820 2017-07-19
1588194690 A Calming Connection-counseling, LLC Counselor 14376 County Road 3490 Ada, Ok 74820, 14376 County Road 3490, Ada, OK 74820 2017-06-13
1447796925 Ada Medical Group Pllc Family Medicine 1150 N. Hills Center, Ada, OK 74820 2017-01-09
Find all providers in zip 74820

Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265907885 Apex Surgery Center, LLC Surgery 2001 Cradduck Road, Ada, OK 74820 2018-10-10
1801030440 Robert L Waddell Md PC Surgery 435 N. Monte Vista, Ada, OK 74820-4676 2009-04-27
1851400642 James Alden Glasgow Surgery 325 N Monte Vista St, Ada, OK 74820-4607 2006-08-29
1265796023 Celeste Coleen Adrian Surgery 435 N Monte Vista St, Ada, OK 74820-4676 2012-06-26
1336433366 Jessica Enix Surgery 1921 Stonecipher Blvd, Ada, OK 74820 2011-06-07
1598910283 Matthew Marcus Mctague Surgery 1921 Stonecipher Dr, Ada, OK 74820 2008-11-21
1477746691 William L. Barrett M.d.p.c. Surgery 520 N Monte Vista St, Suite B, Ada, OK 74820-4674 2007-08-21
1669697926 James A Glasgow M D Inc Surgery 325 N Monte Vista St, Ada, OK 74820-4607 2007-04-13
1760554521 Marcia Monroe Moore Surgery 1921 Stonecipher Blvd, Ada, OK 74820 2006-11-15
1669471454 Larry E Adams Surgery 1921 Stonecipher Blvd, Ada, OK 74820 2005-07-14
Find all providers in ADA

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City ADA
Zip Code 74820

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Dataset Information

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.

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