MEDICARE: MRS. HELGA RENEE PRICE PA C

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	363AM0700X	Medical Physician Assistant	1221	OK
2	363A00000X	Physician Assistant	1221	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
2	1221	OTHER	OK	LICENSE

General Provider Information

NPI Number	:	1215939707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HELGA RENEE PRICE PA C

Provider Business Mailing Address
First Line	:	610 W BYPASS
Second Line	:
City	:	DRUMRIGHT
State	:	OK
Zip	:	74030-5957
Country	:	US
Telephone Number	:	918-382-2300
Fax Number	:	918-382-2392

Provider Business Practice Location Address
First Line	:	610 W BYPASS
Second Line	:
City	:	DRUMRIGHT
State	:	OK
Zip	:	74030-5957
Country	:	US
Telephone Number	:	918-382-2300
Fax Number	:	918-382-2392

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	11/27/2024

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