MEDICARE: ESSENTIAL INTEGRATIVE HEALTH PLLC

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	207X00000X	Orthopaedic Surgery Physician	21476	OK

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	:	1194262097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL INTEGRATIVE HEALTH PLLC

Provider Business Mailing Address
First Line	:	PO BOX 108835
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73101-8835
Country	:	US
Telephone Number	:	405-703-7300
Fax Number	:	877-768-9848

Provider Business Practice Location Address
First Line	:	9060 HARMONY DR STE B
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6253
Country	:	US
Telephone Number	:	405-703-7300
Fax Number	:	877-768-9848

Authorized Official
Title or Position	:	PHYSICIAN / OWNER
Name	:	ARTHUR H CONLEY
Credential	:	MD
Telephone Number	:	405-703-7300

Provider Enumeration Date	:	01/30/2017
Last Update Date	:	04/05/2018

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