Healthcare Provider Details

I. General information

NPI: 1487800512
Provider Name (Legal Business Name): INTEGRIS RURAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 S OAKWOOD RD STE B
ENID OK
73703-4945
US

IV. Provider business mailing address

PO BOX 960353
OKLAHOMA OK
73196-0353
US

V. Phone/Fax

Practice location:
  • Phone: 580-234-1831
  • Fax: 580-234-1834
Mailing address:
  • Phone: 580-548-1367
  • Fax: 580-548-1583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GREG A MEYERS
Title or Position: VICE PRESIDENT
Credential:
Phone: 580-548-1367