Provider Demographics
NPI:1235848466
Name:PHP OK PC
Entity Type:Organization
Organization Name:PHP OK PC
Other - Org Name:PRIMARY HEALTH PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-577-6571
Mailing Address - Street 1:1820 COMMONS CIR STE B
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9518
Mailing Address - Country:US
Mailing Address - Phone:405-577-6571
Mailing Address - Fax:
Practice Address - Street 1:15318 N MAY AVE STE B
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-8864
Practice Address - Country:US
Practice Address - Phone:405-960-8020
Practice Address - Fax:405-970-8025
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHP MANAGEMENT GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-16
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty