Provider Demographics
NPI:1285356139
Name:PRIORITY HEALTH CARE LLC
Entity type:Organization
Organization Name:PRIORITY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-631-9139
Mailing Address - Street 1:5125 E 81ST ST STE 1
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2292
Mailing Address - Country:US
Mailing Address - Phone:918-994-6363
Mailing Address - Fax:539-444-7067
Practice Address - Street 1:5125 E 81ST STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137
Practice Address - Country:US
Practice Address - Phone:918-994-6363
Practice Address - Fax:539-444-7067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty