Cottonwood Family Practice PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25161 Issued in OK

Legal business name

COTTONWOOD FAMILY PRACTICE PLLC

Practice address

615 SW Jennings Ave
Box 2466
Bartlesville, OK 74005-6602

Phone

(918) 876-0495

Fax

(918) 213-4949

NPI assigned

Dec 17, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Craig S Corson, MD

Title

Owner

Phone

(918) 876-0495

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1801199658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2466",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740052466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SW JENNINGS AVE",
            "address_2": "BOX 2466",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740056602",
            "telephone_number": "918-876-0495",
            "fax_number": "918-213-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "CORSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-876-0495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "25161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Bartlesville, OK
• Providers in Bartlesville, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.