# COMMUNITY PHYSICIANS GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043493992
- **Authorized official:** KELLY E CHAMBERS (BILLING MANAGER)
- **Authorized official phone:** (479) 549-3079

## Contact information

- **Practice address:** 419 S WILLIAMS, WESTVILLE, OK 74965
- **Practice address phone:** (918) 723-5456
- **Practice address fax:** (918) 723-4080
- **Mailing address:** PO BOX 1374, SILOAM SPRINGS, AR 72761-1374
- **Mailing address phone:** (479) 549-3079
- **Mailing address fax:** (479) 549-3275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/14/2007
- **Last updated:** 12/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100747540A | — | OK |
| 05 | — | 135299002 | — | AR |
| 01 | — | 5C090 | BCBS | AR |
| 01 | — | CI2710 | RR MEDICARE | AR |
| 01 | — | CI2712 | RR MEDICARE | OK |