Organization
CAREATC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BENDER (DIRECTOR, PRODUCT & DATA MANAGEMENT)
(918) 779-7475
Entity
Organization
Contact information
Practice address
103 W MAIN ST, SOLOMON, KS 67480-9760
(620) 670-9008
(877) 549-7341
Mailing address
4500 S 129TH EAST AVE, SUITE 191, TULSA, OK 74134-5801
(918) 779-7900
(918) 779-7425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/10/2013
Last updated
12/11/2023
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