| Wagoner Hospital Authority | |
|
3501 W Broadway St Muskogee OK 74401-2138 | |
| (918) 913-9408 | |
| Not Available |
| Full Name | Wagoner Hospital Authority |
|---|---|
| Speciality | Clinic/center |
| Location | 3501 W Broadway St, Muskogee, Oklahoma |
| Authorized Official Name and Position | Debi Hamilton (CHAIRMAN) |
| Authorized Official Contact | 9184855514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wagoner Hospital Authority 1200 W Cherokee St Wagoner OK 74467-4624 Ph: () - | Wagoner Hospital Authority 3501 W Broadway St Muskogee OK 74401-2138 Ph: (918) 913-9408 |
| NPI Number | 1568808988 |
|---|---|
| Provider Enumeration Date | 05/13/2013 |
| Last Update Date | 03/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568808988 | NPI | - | NPPES |
| 300522264 | Other | MEDICARE CLINIC PROVIDER NUMBER | |
| 200100890B | Medicaid | OK | |
| 200100890A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2298 (Oklahoma) | Primary |
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