Healthcare Provider Details

I. General information

NPI: 1720265945
Provider Name (Legal Business Name): HELTON RURAL HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W OHIO AVE
COALGATE OK
74538-2827
US

IV. Provider business mailing address

PO BOX 345
COALGATE OK
74538-0345
US

V. Phone/Fax

Practice location:
  • Phone: 580-927-2334
  • Fax: 580-927-9941
Mailing address:
  • Phone: 580-927-2334
  • Fax: 580-927-9941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD J HELTON
Title or Position: OWNER
Credential: D.O.
Phone: 580-927-2334