Organization
CRAIG PHELPS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG PHELPS MD (PHYSICIAN OWNER)
(580) 225-8600
Entity
Organization
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
01
—
DF1591
RAILROAD MEDICARE
OK
Enumeration date
04/26/2007
Last updated
09/24/2007
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