# CRAIG PHELPS MD PC

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

## Provider details

- **NPI number:** 1518187004
- **Authorized official:** CRAIG PHELPS MD (PHYSICIAN OWNER)
- **Authorized official phone:** (580) 225-8600

## Contact information

- **Practice address:** 1710 W 3RD ST, SUITE 103B, ELK CITY, OK 73644-5159
- **Practice address phone:** (580) 225-8600
- **Practice address fax:** (580) 225-8603
- **Mailing address:** PO BOX 1047, ELK CITY, OK 73648-1047
- **Mailing address phone:** (580) 225-8600
- **Mailing address fax:** (580) 225-8603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11010 | OK | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 09/24/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DF1591 | RAILROAD MEDICARE | OK |