Individual
CRAIG PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1710 W 3RD ST, SUITE 103B, ELK CITY, OK 73644-5159
(580) 225-8600
(580) 225-8603
Mailing address
PO BOX 1047, ELK CITY, OK 73648-1047
(580) 225-8600
(580) 225-8603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11010
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100200430A
—
OK
01
—
P00343048
RR MEDICARE
OK
Enumeration date
08/20/2006
Last updated
04/12/2010
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