| Core Clinical Partners | |
|
1000 W Boise Cir Fl 3 Broken Arrow OK 74012-4900 | |
| (918) 994-8000 | |
| Not Available |
| Full Name | Core Clinical Partners |
|---|---|
| Speciality | Internal Medicine |
| Location | 1000 W Boise Cir Fl 3, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Boykin Robinson (CEO) |
| Authorized Official Contact | 4045008147 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Clinical Partners 400 Galleria Pkwy Se Ste 1755 Atlanta GA 30339-5934 Ph: (404) 500-8147 | Core Clinical Partners 1000 W Boise Cir Fl 3 Broken Arrow OK 74012-4900 Ph: (918) 994-8000 |
| NPI Number | 1205588928 |
|---|---|
| Provider Enumeration Date | 01/24/2022 |
| Last Update Date | 12/06/2023 |
| Medicare PECOS PAC ID | 3577959907 |
|---|---|
| Medicare Enrollment ID | O20220411002237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205588928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Brent C Mcanulty |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023201720 PECOS PAC ID: 6709057177 Enrollment ID: I20110914000636 |
| Provider Name | Trang H Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790006591 PECOS PAC ID: 6406007848 Enrollment ID: I20130917000291 |
| Provider Name | Stanley W Tallon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114354727 PECOS PAC ID: 6204067523 Enrollment ID: I20140328001506 |
| Provider Name | Michelle Olmstead-mills |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215228440 PECOS PAC ID: 7012149446 Enrollment ID: I20140717002497 |
| Provider Name | Gary Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134410251 PECOS PAC ID: 9931331337 Enrollment ID: I20140916000976 |
| Provider Name | Jared D Qualls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003279498 PECOS PAC ID: 4688952914 Enrollment ID: I20161020001890 |
| Provider Name | Tiffany J Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215471263 PECOS PAC ID: 7719262922 Enrollment ID: I20170329002351 |
| Provider Name | Linda Ngorima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073026399 PECOS PAC ID: 7618236050 Enrollment ID: I20180111000027 |
| Provider Name | Jacqueline Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972955748 PECOS PAC ID: 6507116043 Enrollment ID: I20180905000526 |
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