Healthcare Provider Details

I. General information

NPI: 1730477043
Provider Name (Legal Business Name): EMMA BETH HARP D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S BLISS AVE
TAHLEQUAH OK
74464-2512
US

IV. Provider business mailing address

1101-1 NORTH PROGRESS AVE
SILOAM SPRINGS AR
72761-4343
US

V. Phone/Fax

Practice location:
  • Phone: 918-458-3360
  • Fax: 918-458-3511
Mailing address:
  • Phone: 479-549-4010
  • Fax: 479-549-3302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5135
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: