Crestcare Family Medicine,pllc | |
817 S Elm Pl Ste 104 Broken Arrow OK 74012-5369 | |
(918) 251-9698 | |
(405) 241-9022 |
Full Name | Crestcare Family Medicine,pllc |
---|---|
Speciality | Family Medicine |
Location | 817 S Elm Pl Ste 104, Broken Arrow, Oklahoma |
Authorized Official Name and Position | Gaurangi M Anklesaria (OWNER) |
Authorized Official Contact | 9182519698 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Crestcare Family Medicine,pllc 817 S Elm Pl Ste 104 Broken Arrow OK 74012-5369 Ph: (918) 251-9698 | Crestcare Family Medicine,pllc 817 S Elm Pl Ste 104 Broken Arrow OK 74012-5369 Ph: (918) 251-9698 |
NPI Number | 1174139554 |
---|---|
Provider Enumeration Date | 09/21/2020 |
Last Update Date | 09/21/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174139554 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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