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NPI Code Detail

MEDICARE: INTEGRIS RURAL HEALTH INC

MEDICARE: INTEGRIS RURAL HEALTH INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467454991
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRIS RURAL HEALTH INC
Provider Business Mailing Address
First Line : PO BOX 960109
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73196-0109
Country : US
Telephone Number : 580-548-1367
Fax Number : 580-548-1583
Provider Business Practice Location Address
First Line : 1805 W GARRIOTT RD
Second Line :
City : ENID
State : OK
Zip : 73703-5526
Country : US
Telephone Number : 580-233-9012
Fax Number : 580-249-4269
Authorized Official
Title or Position : VP RURAL PRACTICE MANAGEMENT
Name : JEFFREY M BROWN
Credential :
Telephone Number : 580-548-1367
Provider Enumeration Date : 08/15/2005
Last Update Date : 01/17/2012

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Directions to “INTEGRIS RURAL HEALTH INC ” Practice Location

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