| Crestcare Family Medicine,pllc | |
|
817 S Elm Pl Ste 104 Broken Arrow OK 74012-5369 | |
| (918) 251-9698 | |
| (405) 241-9022 |
| Full Name | Crestcare Family Medicine,pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 817 S Elm Pl Ste 104, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Gaurangi M Anklesaria (OWNER) |
| Authorized Official Contact | 9182519698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestcare Family Medicine,pllc 817 S Elm Pl Ste 104 Broken Arrow OK 74012-5369 Ph: (918) 251-9698 | Crestcare Family Medicine,pllc 817 S Elm Pl Ste 104 Broken Arrow OK 74012-5369 Ph: (918) 251-9698 |
| NPI Number | 1174139554 |
|---|---|
| Provider Enumeration Date | 09/21/2020 |
| Last Update Date | 09/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174139554 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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