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628 E Creek Ave Mcalester OK 74501-6930 | |
| (918) 421-3500 | |
| (918) 423-2370 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 628 E Creek Ave, Mcalester, Oklahoma |
| Authorized Official Name and Position | R. Carroll Huggins (DIRECTOR/CEO) |
| Authorized Official Contact | 9189673325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1404 Mcalester OK 74502-1404 Ph: (918) 421-3500 | 628 E Creek Ave Mcalester OK 74501-6930 Ph: (918) 421-3500 |
| NPI Number | 1093145914 |
|---|---|
| Provider Enumeration Date | 11/13/2013 |
| Last Update Date | 11/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093145914 | NPI | - | NPPES |
| 100680370U | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 01-1372703 (Oklahoma) | Primary |
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