Provider Demographics
NPI:1154868701
Name:ELKVIEW PHYSICIAN GROUP
Entity type:Organization
Organization Name:ELKVIEW PHYSICIAN GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-726-1960
Mailing Address - Street 1:429 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:OK
Mailing Address - Zip Code:73651-1615
Mailing Address - Country:US
Mailing Address - Phone:580-726-1900
Mailing Address - Fax:
Practice Address - Street 1:429 W ELM ST
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:OK
Practice Address - Zip Code:73651-1615
Practice Address - Country:US
Practice Address - Phone:580-726-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELKVIEW GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty