ELMBROOK CLINICAL SERVICES LLC NPI 1649951211

NPI Information

NPI: 1649951211
Provider Name: ELMBROOK CLINICAL SERVICES LLC
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Organization

Specialization: Gerontology

Address:
1908 12TH AVE NW
SUITE E
ARDMORE, OK
ZIP 73401
Phone: (580) 226-3055
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ELMBROOK CLINICAL SERVICES LLC is a gerontology nurse practitioner in Ardmore, OK. ELMBROOK CLINICAL SERVICES LLC NPI is 1649951211. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1908 12TH AVE NW
SUITE E
ARDMORE, OK
ZIP 73401-255
Phone: (580) 226-3055
Fax: (580) 226-3121

The provider's authorized official is Tom C Coble .
The authorized official title is Sole Member/initial Manager and has the following contact phone number (580) 220-7093.

The enumeration date for this NPI number is 7/27/2023 and was last updated on 1/5/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	No
2	363LF0000X	Nurse Practitioner	Family	No
3	363LG0600X	Nurse Practitioner	Gerontology	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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