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GREGORY P. KELLEY D.O. INC. NPI 1689768285


NPI Information

NPI: 1689768285
Provider Name: GREGORY P. KELLEY D.O. INC.

Doing Business As: KELLEY FAMILY CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 37D0469542

Address:
13190 NE 23RD STREET
CHOCTAW, OK
ZIP 73020
Phone: (405) 769-7201
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GREGORY P. KELLEY D.O. INC. is a family medicine in Choctaw, OK. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GREGORY P. KELLEY D.O. INC. NPI is 1689768285. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Kelley Family Clinic.

The provider's business location address is:

13190 NE 23RD STREET
CHOCTAW, OK
ZIP 73020
Phone: (405) 769-7201
Fax: (405) 769-4034

The provider's authorized official is Nan Kelley .
The authorized official title is Office Manager and has the following contact phone number (405) 769-7201.

The CLIA number assigned to this NPI record is 37D0469542 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine2127OKLAHOMAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1452023528002OTHEROKLAHOMABLUE CROSS BLUE SHIELD
273020A002OTHEROKLAHOMATRICARE SOUTH /LIFE
34335747OTHEROKLAHOMAAETNA HEALTHCARE
4452023528002OTHEROKLAHOMACGS CLAIMS
5452023528002OTHEROKLAHOMABC/BS FEDERAL
6C2138OTHEROKLAHOMABLUELINCS HMO

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

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