Organization
GREGORY P. KELLEY D.O. INC.
Active
Other names
kelley family clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NAN KELLEY (OFFICE MANAGER)
(405) 769-7201
Entity
Organization
Contact information
Practice address
13190 NE 23RD STREET, CHOCTAW, OK 73020
(405) 769-7201
(405) 769-4034
Mailing address
13190 NE 23RD STREET, CHOCTAW, OK 73020
(405) 769-7201
(405) 769-4034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2127
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4335747
AETNA HEALTHCARE
OK
01
—
452023528002
BC/BS FEDERAL
OK
01
—
73020A002
TRICARE SOUTH /LIFE
OK
01
—
C2138
BLUELINCS HMO
OK
Enumeration date
10/03/2006
Last updated
08/22/2020
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