# ALPHA M.D., PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr. H's Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245978774
- **Authorized official:** JACOB HOSTETLER MD (MANAGER)
- **Authorized official phone:** (918) 877-1211

## Contact information

- **Practice address:** 4602 US HIGHWAY 59, GROVE, OK 74344-4229
- **Practice address phone:** (918) 877-1211
- **Practice address fax:** (918) 877-1216
- **Mailing address:** PO BOX 450130, GROVE, OK 74345-0130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2022
- **Last updated:** 11/13/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201090500A | — | OK |