Organization
ALPHA M.D., PLC
Active
Other names
Dr. H's Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB HOSTETLER MD (MANAGER)
(918) 877-1211
Entity
Organization
Contact information
Practice address
4602 US HIGHWAY 59, GROVE, OK 74344-4229
(918) 877-1211
(918) 877-1216
Mailing address
PO BOX 450130, GROVE, OK 74345-0130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201090500A
—
OK
Enumeration date
05/24/2022
Last updated
11/13/2022
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