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Point of Service

This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

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Contact Information

RYIAN CRENSHAW
410 FAIRVIEW AVE
PONCA CITY, OK  74601-1922
 Phone: 580-749-4227
 Fax:
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Point of Service

 305S00000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1639565153
Entity Organization
Organization subpart 1 Not specified
Enumeration date 04/10/2015
Last updated 03/30/2021 - About 5 years ago
Identifiers
OK License # 1069
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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