| Craig Phelps MD PC | |
|
1710 W 3rd St Suite 103b Elk City OK 73644-5159 | |
| (580) 225-8600 | |
| (580) 225-8603 |
| Full Name | Craig Phelps MD PC |
|---|---|
| Speciality | Family Medicine |
| Location | 1710 W 3rd St, Elk City, Oklahoma |
| Authorized Official Name and Position | Craig Phelps (PHYSICIAN OWNER) |
| Authorized Official Contact | 5802258600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Craig Phelps MD PC Po Box 1047 Elk City OK 73648-1047 Ph: (580) 225-8600 | Craig Phelps MD PC 1710 W 3rd St Suite 103b Elk City OK 73644-5159 Ph: (580) 225-8600 |
| NPI Number | 1518187004 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 09/24/2007 |
| Medicare PECOS PAC ID | 6305979915 |
|---|---|
| Medicare Enrollment ID | O20100803001025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518187004 | NPI | - | NPPES |
| DF1591 | Other | OK | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11010 (Oklahoma) | Primary |
| Provider Name | Craig a Phelps |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295840288 PECOS PAC ID: 8921031832 Enrollment ID: I20100803001053 |
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