| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 19 Kiamichi Road, Eufaula, Oklahoma |
| Authorized Official Name and Position | David Keith (PRESIDENT) |
| Authorized Official Contact | 9184218001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
19 Kiamichi Road Eufaula OK 74432 Ph: (918) 452-2330 | 19 Kiamichi Road Eufaula OK 74432 Ph: (918) 452-2330 |
| NPI Number | 1659316776 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 10/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659316776 | NPI | - | NPPES |
| 100710530B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 2203 (Oklahoma) | Primary |
| 282NR1301X | General Acute Care Hospital - Rural | 2203 (Oklahoma) | Secondary |
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