OrganizationActive
Elmbrook Clinical Services LLC
NPI 1649951211 · Gerontology Nurse Practitioner · Ardmore, OK
Provider details
- NPI number
- 1649951211
- Entity type
- Organization
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Tom Coble, Sole Member/Initial Manager(580) 220-7093
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Primary Care Nurse Practitioner363LP2300X
Physician Assistants & Advanced Practice Nursing Providers
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1908 12th Ave Nw
Suite E
Ardmore, OK 73401-1255
Phone: (580) 226-3055
Fax: (580) 226-3121
Approximate (ZIP-level) locationGet directions
Mailing address
1908 12th Ave Nw
Ardmore, OK 73401-1255
Registry dates
- Enumerated
- 2023-07-27
- Last updated
- 2024-01-05
- Certified
- 2024-01-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.