| Doctor Name: | MR. AERIC WYNN CREEKMORE |
| NPI Number: | 1144625732 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | 80829 |
| Business Practice Address: | 100 Mcdougal Dr Holdenville, OK - 748482822 |
| Business Phone Number: | 4053792150 |
| Business Fax Number: | |
| Mailing Address: | 100 Mcdougal Dr, HOLDENVILLE |
| State: | OK |
| Postal Code: | 748482822 |
| Phone Number: | 4053792150 |
| Fax Number: | |
| NPI Enumeration Date: | 10/26/2014 |
| NPI Last Update Date: | 10/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 80829 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |