Provider Demographics
NPI:1134300049
Name:MELTON HEALTH AND MEDICAL SERVICES
Entity Type:Organization
Organization Name:MELTON HEALTH AND MEDICAL SERVICES
Other - Org Name:OKLAHOMA NEUROPSYCHIATRIC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-764-9300
Mailing Address - Street 1:PO BOX 35264
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74153-0264
Mailing Address - Country:US
Mailing Address - Phone:918-764-9300
Mailing Address - Fax:
Practice Address - Street 1:1129 S ASPEN AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4859
Practice Address - Country:US
Practice Address - Phone:918-764-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OKLAHOMA NEUROPSYCHIATRIC INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-19
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24098261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health