Healthcare Provider Details

I. General information

NPI: 1871971150
Provider Name (Legal Business Name): ESSENTIAL INTEGRATIVE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 SW 89TH ST STE 200
OKLAHOMA CITY OK
73159
US

IV. Provider business mailing address

PO BOX 734726
DALLAS TX
75373-4726
US

V. Phone/Fax

Practice location:
  • Phone: 405-703-7300
  • Fax: 405-737-0221
Mailing address:
  • Phone: 405-673-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number21476
License Number StateOK

VIII. Authorized Official

Name: ARTHUR H CONLEY III
Title or Position: ORTHOPEDIC SURGEON / OWNER
Credential: M.D.
Phone: 405-673-3280