Alpha M.D., PLC
Organization Active NPI Medical Specialty Clinic/Center · Grove, OK
NPI 1245978774 · NPPES record last updated Nov 13, 2022
Key facts
- NPI
- 1245978774
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- Legal business name
- ALPHA M.D., PLC
- Practice address
- 4602 US Highway 59
Grove, OK 74344-4229 - Phone
- (918) 877-1211
- Fax
- (918) 877-1216
- NPI assigned
- May 24, 2022
- Organization subpart
- No
Authorized official
- Name
- Jacob Hostetler, MD
- Title
- Manager
- Phone
- (918) 877-1211
Practitioners 1
-
Jacob Hostetler, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220623001960 | OK | Part B Supplier - Clinic/Group Practice | 2961881867 |
Receives reassigned benefits from 1 practitioner Practice locations: Grove, OK |
National Provider Directory
Locations
4602 US Highway 59 N
Grove, OK 74344
Phone (918) 787-2242
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Medical Specialty Clinic/Center | 261QM2500X | Yes |
Addresses
Primary practice location
4602 US Highway 59
Grove, OK 74344-4229
Mailing address
PO Box 450130
Grove, OK 74345-0130
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201090500A | Medicaid | OK |
Other names
- Dr. H's Family Medicine
Other providers in Grove, OK
- Matthew Kyle Allen
- Richard Darren Allen
- Nicholas Allgood
- Allsup Chiropractic Clinic Inc.
- Paul Daniel Allsup
- Amedisys Oklahoma, LLC
- Olivia Valentine Anderson
- Shawn Michael Anderson
- Jennifer Lynne Andrews
- Anesthesia Associates of Grand Lake
All providers in Grove, OK · Medical Specialty Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.