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General NPI Number Information
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NPI Number | 1124916721
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Entity Type | Organization
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Legal Business Name | VALLEY HOPE MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 7718 E 91ST ST STE 120
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City | TULSA
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State | OK
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Zip | 74133-6051
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Country | US
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Telephone | 918-398-9928
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Fax | 539-812-2600
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Provider Business Mailing Address
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Address Line | PO BOX 800081
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City | KANSAS CITY
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State | MO
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Zip | 64180-0081
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Country | US
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Telephone | 785-877-5169
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Fax | 785-877-4104
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Authorized Official
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Title or Position | DIR OF CONTRACT ADMIN
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Name | KATHY ERBERT
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Credential |
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Telephone | 785-877-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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