| Choctaw Nation Health Clinic-broken Bow | |
|
205 E 3rd St Broken Bow OK 74728-4119 | |
| (918) 567-7000 | |
| (918) 567-7041 |
| Full Name | Choctaw Nation Health Clinic-broken Bow |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 205 E 3rd St, Broken Bow, Oklahoma |
| Authorized Official Name and Position | Teresa Kay Jackson (ADMINISTRATOR) |
| Authorized Official Contact | 9185677000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Choctaw Nation Health Clinic-broken Bow 1 Choctaw Way Talihina OK 74571-2022 Ph: (918) 567-7000 | Choctaw Nation Health Clinic-broken Bow 205 E 3rd St Broken Bow OK 74728-4119 Ph: (918) 567-7000 |
| NPI Number | 1770559619 |
|---|---|
| Provider Enumeration Date | 02/28/2006 |
| Last Update Date | 01/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770559619 | NPI | - | NPPES |
| 100699600I | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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