| Gilstrap Clinics Pc | |
|
3900 S 113th West Ave Sand Springs OK 74063-2724 | |
| (918) 241-3901 | |
| (918) 241-3902 |
| Full Name | Gilstrap Clinics Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3900 S 113th West Ave, Sand Springs, Oklahoma |
| Authorized Official Name and Position | Russell D Gilstrap (PRESIDENT/OWNER) |
| Authorized Official Contact | 9182413901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilstrap Clinics Pc 3900 S 113th West Ave Sand Springs OK 74063-2724 Ph: (918) 241-3901 | Gilstrap Clinics Pc 3900 S 113th West Ave Sand Springs OK 74063-2724 Ph: (918) 241-3901 |
| NPI Number | 1063877017 |
|---|---|
| Provider Enumeration Date | 12/17/2015 |
| Last Update Date | 12/17/2015 |
| Medicare PECOS PAC ID | 6507162401 |
|---|---|
| Medicare Enrollment ID | O20160302001316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063877017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Russell Dale Gilstrap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659455517 PECOS PAC ID: 0446555494 Enrollment ID: I20160229002192 |
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