Most Relevant Information
Provider Data
| NPI Number: | 1003806852 |
| Provider Name: | KELLY J ELERICK PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 915 |
Most Important Dates
| Enumeration Date: | 10/24/2005 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
300 ROCKEFELLER DR
MUSKOGEE
OK
744015075
Practice Location Phone/Fax
| Phone: | 9187819466 |
| Fax: |
Provider Mailing Location
LOCKBOX #17
2424 E. 21ST #100
TULSA
OK
741141711
Provider Mailing Phone/Fax
| Phone: | 8663218433 |
| Fax: |