Acacia Medical Group

LBN: Acacia Medical Group
Acacia Medical Group is an health care organization with primary practice located at 2010 W Houston St , Broken Arrow OK 74012-8303. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Acacia Medical Group can be contacted via phone (918) 258-2641, or through Whitehouse, Keith via phone (918) 258-2641.

Contact Information

Primary practice address
2010 W Houston St Broken Arrow OK 74012-8303
Phone: (918) 258-2641
Fax: (918) 259-1905
Website:
Map and Directions
Authorized official contact:
Name: Whitehouse, Keith
Phone: (918) 258-2641

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1851400659
LBN Legal business name Acacia Medical Group
DBA Doing business as
Authorized official Whitehouse, Keith
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2006
Last updated Jun 12th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851400659 NPPES
Oklahoma MEDICAID 200069800A

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