Provider Demographics
NPI:1194262097
Name:ESSENTIAL INTEGRATIVE HEALTH PLLC
Entity type:Organization
Organization Name:ESSENTIAL INTEGRATIVE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:H
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-703-7300
Mailing Address - Street 1:PO BOX 108835
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73101-8835
Mailing Address - Country:US
Mailing Address - Phone:405-703-7300
Mailing Address - Fax:877-768-9848
Practice Address - Street 1:9060 HARMONY DR STE B
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6253
Practice Address - Country:US
Practice Address - Phone:405-703-7300
Practice Address - Fax:877-768-9848
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESSENTIAL INTEGRATIVE HEALTH PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-30
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21476207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200585150BMedicaid
OK416349Medicare PIN