| |
2204 E Main St Stigler OK 74462-2822 | |
(915) 567-7000 | |
(918) 567-7041 |
Full Name | |
---|---|
Speciality | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy |
Location | 2204 E Main St, Stigler, Oklahoma |
Authorized Official Name and Position | Teresa K Jackson (ADMINISTRATOR) |
Authorized Official Contact | 9185677000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
2204 E Main St Stigler OK 74462-2822 Ph: (915) 567-7000 | 2204 E Main St Stigler OK 74462-2822 Ph: (915) 567-7000 |
NPI Number | 1609924471 |
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Provider Enumeration Date | 01/08/2007 |
Last Update Date | 05/03/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609924471 | NPI | - | NPPES |
100699600S | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 584848 (Oklahoma) | Secondary |
332800000X | Indian Health Service/tribal/urban Indian Health (i/t/u) Pharmacy | 58-4848 (Oklahoma) | Primary |
Green Country Hospitalists, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 Nw 5th St, Stigler, OK 74462 Phone: 918-967-0072 Fax: 918-967-5040 | |
Haskell Regional Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 Nw H St, Stigler, OK 74462 Phone: 888-339-7339 | |