Provider Demographics
NPI:1013991835
Name:E R ASSOCIATES INC
Entity Type:Organization
Organization Name:E R ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:D
Authorized Official - Last Name:ENDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-682-5397
Mailing Address - Street 1:1524 W OKMULGEE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-6741
Mailing Address - Country:US
Mailing Address - Phone:918-682-5397
Mailing Address - Fax:918-682-2663
Practice Address - Street 1:1524 W OKMULGEE ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-6741
Practice Address - Country:US
Practice Address - Phone:918-682-5397
Practice Address - Fax:918-682-2663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3027207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
445587563001OtherBCBS
F35608Medicare UPIN