Provider Demographics
NPI:1184222705
Name:ESSENTIAL MD, PLLC
Entity Type:Organization
Organization Name:ESSENTIAL MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MCGHEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-600-2233
Mailing Address - Street 1:6316 E 102ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-7061
Mailing Address - Country:US
Mailing Address - Phone:918-600-2233
Mailing Address - Fax:918-600-2234
Practice Address - Street 1:6316 E 102ND ST STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-7061
Practice Address - Country:US
Practice Address - Phone:918-600-2233
Practice Address - Fax:918-600-2234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care