Provider Demographics
NPI:1184003790
Name:ADVANCE PHYSICIANS GROUP LLC
Entity Type:Organization
Organization Name:ADVANCE PHYSICIANS GROUP LLC
Other - Org Name:FIRST MED URGENT CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:PENICK
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:405-285-8799
Mailing Address - Street 1:1221 N KELLY AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-4865
Mailing Address - Country:US
Mailing Address - Phone:405-285-8799
Mailing Address - Fax:405-471-6401
Practice Address - Street 1:13401 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142
Practice Address - Country:US
Practice Address - Phone:405-285-8799
Practice Address - Fax:405-471-6401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCE PHYSICIANS GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care