Provider Demographics
NPI: | 1568151322 |
---|---|
Name: | MAIN STREET HEALTH PARTNERS, P.C. |
Entity Type: | Organization |
Organization Name: | MAIN STREET HEALTH PARTNERS, P.C. |
Other - Org Name: | MAIN STREET HEALTH MEDICAL PARTNERS-OKLAHOMA |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | DIRECTOR OF OPERATIONS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | BARBARA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | EARPS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 615-962-3405 |
Mailing Address - Street 1: | 900 MAIN ST |
Mailing Address - Street 2: | |
Mailing Address - City: | NASHVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37206-3610 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 615-962-3405 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7633 E 63RD PL STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | TULSA |
Practice Address - State: | OK |
Practice Address - Zip Code: | 74133-1202 |
Practice Address - Country: | US |
Practice Address - Phone: | 918-489-4500 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-05-05 |
Last Update Date: | 2023-05-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty |