TEAM CLINICS AH LLC NPI 1639796436

NPI Information

NPI: 1639796436
Provider Name: TEAM CLINICS AH LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2701 S ELM PL
BROKEN ARROW, OK
ZIP 74012
Phone: (405) 546-4130
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TEAM CLINICS AH LLC is a primary care clinic center in Broken Arrow, OK. TEAM CLINICS AH LLC NPI is 1639796436. The provider is registered as an organization entity type.

The provider's business location address is:

2701 S ELM PL
BROKEN ARROW, OK
ZIP 74012-852
Phone: (405) 546-4130

The provider's authorized official is Trevor Nutt .
The authorized official title is Ceo and has the following contact phone number (405) 546-4130.

The enumeration date for this NPI number is 6/29/2020 and was last updated on 6/22/2021.

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	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200782030	MEDICAID	OKLAHOMA

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: 4/28/2024

NPI Synchronization or Removal

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