Phoenix Primary Care, LLC
Organization Active NPI Primary Care Clinic/Center · Pawnee, OK
NPI 1952890337 · NPPES record last updated Jan 8, 2020
Key facts
- NPI
- 1952890337
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- PHOENIX PRIMARY CARE, LLC
- Practice address
- 557 Harrison St
Pawnee, OK 74058-2566 - Phone
- (918) 762-5050
- Fax
- (877) 515-8550
- NPI assigned
- May 1, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Niko Koliastasis
- Title
- Ceo
- Phone
- (918) 636-3930
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
557 Harrison St
Pawnee, OK 74058-2566
Mailing address
209 N Oak St
Sallisaw, OK 74955-4639
Phone (918) 503-6276
Other providers in Pawnee, OK
- Pawnee Municipal Hospital Authority
- Pawnee Nation Mental Health, LLC
- Pawnee Public Schools
- Phoenix Health Care, LLC
- Phoenix Medical Center
- Katherine A Pratt
- Jodi Price
- Alexcia Ramirez
- Renee' Yvonne Raney-Cravens
- Blake E Raper
All providers in Pawnee, OK · Primary Care 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 Jan 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.