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817 S Elm Pl Suite 105 Broken Arrow OK 74012-5369 | |
(479) 242-2888 | |
(479) 242-2889 |
Full Name | |
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Speciality | Internal Medicine - Gastroenterology |
Location | 817 S Elm Pl, Broken Arrow, Oklahoma |
Authorized Official Name and Position | Ihab Herraka (PRESIDENT) |
Authorized Official Contact | 4792422888 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3416 Old Greenwood Rd Fort Smith AR 72903-5462 Ph: (479) 242-2888 | 817 S Elm Pl Suite 105 Broken Arrow OK 74012-5369 Ph: (479) 242-2888 |
NPI Number | 1992254346 |
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Provider Enumeration Date | 09/27/2016 |
Last Update Date | 09/27/2016 |
Identifier | Type | State | Issuer |
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1992254346 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RG0100X | Internal Medicine - Gastroenterology | (Arkansas) | Primary |
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