Organization
BROKEN ARROW FAMILY PRACTICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS HOLTE M.D. (OWNER)
(918) 251-2273
Entity
Organization
Contact information
Practice address
817 S ELM PL STE A, BROKEN ARROW, OK 74012-5369
(918) 251-2273
(918) 258-6446
Mailing address
817 S ELM PL STE A, BROKEN ARROW, OK 74012-5369
(918) 251-2273
(918) 258-6446
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100172440D
—
OK
01
—
P00389602
RAILROAD MEDICARE
—
Enumeration date
03/15/2007
Last updated
06/27/2008
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