Individual provider · NPI-1

Kelly J Elerick, PA

Physician Assistant, Medical · Muskogee, OK

NPI number1003806852
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1003806852
Entity type
Individual (NPI-1)
Name
Kelly J Elerick
Credential
PA
Sex
Male
Sole proprietor
No
Enumeration date
Oct 24, 2005
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AM0700X Physician Assistant, Medical915OKYes

Practice location

300 Rockefeller Dr
Muskogee, OK 74401-5075

Phone 918-781-9466

Mailing address

Lockbox #17
2424 E. 21st #100
Tulsa, OK 74114-1711

Phone 866-321-8433

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physician Assistant, Medical providers in Muskogee, OK