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General NPI Number Information
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NPI Number | 1801703467
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Entity Type | Organization
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Legal Business Name | APPELLO ADVANCED PRIMARY CARE OF OKLAHOMA, LLC
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 415 ROGERS AVE
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City | FORT SMITH
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State | AR
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Zip | 72901-1903
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Country | US
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Telephone | 479-783-4672
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Fax |
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Provider Business Mailing Address
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Address Line | 415 ROGERS AVE
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City | FORT SMITH
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State | AR
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Zip | 72901-1903
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Country | US
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Telephone | 479-783-4672
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JASON LEE
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Credential |
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Telephone | 501-650-8348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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