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NPI Code Detail

MEDICARE: LAWTON INDIAN HOSPITAL

MEDICARE: LAWTON INDIAN HOSPITAL
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
1261Q00000XClinic/Center
2282N00000XGeneral Acute Care Hospital21,818OK

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 : 1760489223
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAWTON INDIAN HOSPITAL
Provider Business Mailing Address
First Line : 1515 NE LAWRIE TATUM RD
Second Line :
City : LAWTON
State : OK
Zip : 73507-3002
Country : US
Telephone Number : 580-354-5150
Fax Number : 580-354-5148
Provider Business Practice Location Address
First Line : 1515 NE LAWRIE TATUM RD
Second Line :
City : LAWTON
State : OK
Zip : 73507-3002
Country : US
Telephone Number : 580-354-5150
Fax Number :
Authorized Official
Title or Position : CEO
Name : BRIAN WREN
Credential :
Telephone Number : 580-354-5407
Provider Enumeration Date : 06/30/2005
Last Update Date : 02/11/2025

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1770582868 — LARRY C ATWOOD M.D.
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Directions to “LAWTON INDIAN HOSPITAL ” Practice Location

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