Provider Demographics
NPI:1558187260
Name:UPFRONT HEALTH, LLC
Entity type:Organization
Organization Name:UPFRONT HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-309-9049
Mailing Address - Street 1:PO BOX 945
Mailing Address - Street 2:
Mailing Address - City:SEILING
Mailing Address - State:OK
Mailing Address - Zip Code:73663-0945
Mailing Address - Country:US
Mailing Address - Phone:580-309-9049
Mailing Address - Fax:580-826-9697
Practice Address - Street 1:204 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SEILING
Practice Address - State:OK
Practice Address - Zip Code:73663-6676
Practice Address - Country:US
Practice Address - Phone:580-309-9049
Practice Address - Fax:580-826-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty