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1154317998

NPI Code Detail

MEDICARE: MCALESTER MEDICAL SERVICES, LLC

MEDICARE: MCALESTER MEDICAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician
2	207V00000X	Obstetrics & Gynecology Physician
3	207RC0000X	Cardiovascular Disease Physician
4	207X00000X	Orthopaedic Surgery Physician
5	208600000X	Surgery Physician
6	208800000X	Urology Physician
7	207Q00000X	Family Medicine Physician
8	2084N0400X	Neurology Physician
9	363A00000X	Physician Assistant
10	363L00000X	Nurse Practitioner
11	2083X0100X	Occupational Medicine Physician
12	261QU0200X	Urgent Care Clinic/Center
13	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154317998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCALESTER MEDICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	1 E CLARK BASS BLVD
Second Line	:
City	:	MCALESTER
State	:	OK
Zip	:	74501-4209
Country	:	US
Telephone Number	:	918-421-6987
Fax Number	:	918-421-6698

Provider Business Practice Location Address
First Line	:	1 E CLARK BASS BLVD
Second Line	:
City	:	MCALESTER
State	:	OK
Zip	:	74501-4209
Country	:	US
Telephone Number	:	918-421-6987
Fax Number	:	918-421-6698

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. DAVID N KEITH
Credential	:
Telephone Number	:	918-426-1800

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	04/29/2016

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Directions to “MCALESTER MEDICAL SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

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