| Total Eclipse Dmh Pllc | |
|
817 S Elm Pl Ste C Broken Arrow OK 74012-5369 | |
| (918) 940-4734 | |
| (918) 940-4737 |
| Full Name | Total Eclipse Dmh Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 817 S Elm Pl Ste C, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Dustin Oleath Hayes (PHYSICIAN) |
| Authorized Official Contact | 4694279708 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Eclipse Dmh Pllc 817 S Elm Pl Ste C Broken Arrow OK 74012-5369 Ph: (918) 940-4734 | Total Eclipse Dmh Pllc 817 S Elm Pl Ste C Broken Arrow OK 74012-5369 Ph: (918) 940-4734 |
| NPI Number | 1447972864 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 09/13/2022 |
| Certification Date | 09/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447972864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary |
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