PROACTIVE MD OK LLC NPI 1649943176

NPI Information

NPI: 1649943176
Provider Name: PROACTIVE MD OK, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 37D2232698

Address:
6606 E 540 RD
CLAREMORE, OK
ZIP 74019
Phone: (918) 965-0220
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PROACTIVE MD OK, LLC is a primary care clinic center in Claremore, OK. PROACTIVE MD OK, LLC NPI is 1649943176. The provider is registered as an organization entity type.

The provider's business location address is:

6606 E 540 RD
CLAREMORE, OK
ZIP 74019-534
Phone: (918) 965-0220

The provider's authorized official is Jan Hopkins .
The authorized official title is Assoc. Ops Mgr and has the following contact phone number (864) 501-0751.

The CLIA number assigned to this NPI record is 37D2232698 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2021 and was last updated on 7/30/2021.

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

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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