Organization
BRISTOW ENDEAVOR HEALTHCARE, LLC
Active
Other names
CORE Outreach Specialists, Bristow Family Practice, Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA KAY WHITAKER (CREDENTIALING COORDINATOR)
(918) 701-2313
Entity
Organization
Contact information
Practice address
519 N MAIN ST, BRISTOW, OK 74010-2016
(918) 367-6611
(918) 367-9915
Mailing address
1809 E 13TH ST STE 300, TULSA, OK 74104-4431
(918) 701-2313
(539) 235-0028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
12/12/2013
Last updated
11/18/2022
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