EASTSIDE CLINIC NPI 1023295193

Family Medicine in Tahlequah, OK

NPI 1023295193 Organization Family Medicine

About EASTSIDE CLINIC

Eastside Clinic is a primary care provider established in Tahlequah, Oklahoma specializing in family medicine. The NPI number of Eastside Clinic is 1023295193 and was assigned on January 2008. The practitioner's primary taxonomy code is 207Q00000X with license number 15674 (OK). The provider is registered as an organization and their NPI record was last updated 13 years ago. Eastside Clinic operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. James Mark Seratt M.d. (Owner/doctor)

A primary care provider (PCP) like Eastside Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

NPI

1023295193

Provider NameEASTSIDE CLINIC
Provider Location Address22408 HIGHWAY 51 TAHLEQUAH, OK 74464
Provider Mailing AddressPO BOX 59 TAHLEQUAH, OK 74465
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date01-30-2008
Last Update Date07-28-2008


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.15674
License StateOK
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

EASTSIDE CLINIC
22408 HIGHWAY 51
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 456-6250
Fax: (918) 456-4080

Get Directions


Mailing Address

EASTSIDE CLINIC
PO BOX 59
TAHLEQUAH, OK
ZIP 74465
Phone: (918) 456-6250
Fax: (918) 456-4080



Authorized Official

Authorized Official NameDR. JAMES MARK SERATT M.D.
Authorized Official TitleOWNER/DOCTOR
Authorized Official Phone(918) 456-6250

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
=========OTHER (01)OK
800522162MEDICARE PIN (08)OK
C95468OTHER (01)OK
4111208OTHER (01)OK
110118510AMEDICAID (05)OK
445569081002OTHER (01)OK

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1568453918 JAMES MARK SERATT MD
Individual
Family Medicine22408 HIGHWAY 51
TAHLEQUAH, OK 74464
(918) 456-6250

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.