Healthcare Provider Details

I. General information

NPI: 1730193202
Provider Name (Legal Business Name): BAPTIST HEALTHCARE OF OKLAHOMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 04/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S 3RD ST
ENID OK
73701-5737
US

IV. Provider business mailing address

PO BOX 3187
ENID OK
73702-3187
US

V. Phone/Fax

Practice location:
  • Phone: 580-233-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number2349
License Number StateOK

VIII. Authorized Official

Name: C BRUCE LAWRENCE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 405-949-6066