MEDICARE: FOOT AND ANKLE CLINIC OF WESTERN OKLAHOMA, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	230	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00162625	OTHER	OK	RAILROAD MEDICARE
3	200522085	OTHER	OK	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821264920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT AND ANKLE CLINIC OF WESTERN OKLAHOMA, PLLC

Provider Business Mailing Address
First Line	:	207 S 30TH STREET
Second Line	:
City	:	CLINTON
State	:	OK
Zip	:	73601
Country	:	US
Telephone Number	:	580-323-5800
Fax Number	:	580-323-5802

Provider Business Practice Location Address
First Line	:	900 N MAIN ST
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-9998
Country	:	US
Telephone Number	:	580-225-9955
Fax Number	:	580-225-9954

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRADLEY DEWAYNE NELSON
Credential	:	DPM
Telephone Number	:	580-323-5800

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	08/28/2025

Similar Medicare Providers

1588021521 — VALERIE BRUST RN, BSN
Practice Location Address:

217 ELK AVE
CRESTED BUTTE, CO
81224-9998

Practice Phone: 970-390-9080
Practice Fax:

1003837774 — MR. RENE NARCISO DEL ROSARIO D.D.S
Practice Location Address:

32364 DYER ST.
UNION CITY, CA
94587-9998

Practice Phone: 510-324-2000
Practice Fax: 510-288-1394

1447265699 — WALGREEN CO
Practice Location Address:

9998 FRONT BEACH RD
PANAMA CITY BEACH, FL
32407-4137

Practice Phone: 850-236-1383
Practice Fax:

1316954456 — R. L. TOMS, INC.
Practice Location Address:

204 HALEY RD.
JOHNSON CITY, TX
78636-9998

Practice Phone: 830-868-4039
Practice Fax: 830-868-4095

1184741084 — DR. DONALD RAY CHADWELL MD
Practice Location Address:

7900 MID AMERICA BLVD
OKLAHOMA CITY, OK
73135-9998

Practice Phone: 405-650-0306
Practice Fax:

1922267905 — EDWARD E ROTAN MD INC
Practice Location Address:

2180 MCCULLOCH , SUITE 102
LAKE HAVASU CITY, AZ
86403-9998

Practice Phone: 951-809-3746
Practice Fax:

Directions to “FOOT AND ANKLE CLINIC OF WESTERN OKLAHOMA, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.