Healthcare Provider Details

I. General information

NPI: 1497561898
Provider Name (Legal Business Name): MCARTHUR FAMILY CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 CLYDE AVE
ELK CITY OK
73644-1934
US

IV. Provider business mailing address

103 CLYDE AVE
ELK CITY OK
73644-1934
US

V. Phone/Fax

Practice location:
  • Phone: 580-303-5025
  • Fax: 580-303-5030
Mailing address:
  • Phone: 580-303-5025
  • Fax: 580-303-5030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KASEE MCARTHUR
Title or Position: OWNER
Credential: APRN C-NP
Phone: 580-303-5025