Healthcare Provider Details

I. General information

NPI: 1093725798
Provider Name (Legal Business Name): CREEK NATION HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 ALEXANDER DRIVE
EUFAULA OK
74432
US

IV. Provider business mailing address

DEPT 1467
TULSA OK
74182-0001
US

V. Phone/Fax

Practice location:
  • Phone: 918-618-2168
  • Fax: 918-618-2169
Mailing address:
  • Phone: 918-756-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHAWN TERRY
Title or Position: SECRETARY OF HEALTH
Credential:
Phone: 918-756-3334