Healthcare Provider Details

I. General information

NPI: 1215930359
Provider Name (Legal Business Name): CITY OF KINGFISHER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 S MAIN ST
KINGFISHER OK
73750-3239
US

IV. Provider business mailing address

301 N MAIN ST
KINGFISHER OK
73750-2749
US

V. Phone/Fax

Practice location:
  • Phone: 405-375-4070
  • Fax: 405-375-3374
Mailing address:
  • Phone: 405-375-4070
  • Fax: 405-375-3374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberEMS147
License Number StateOK

VIII. Authorized Official

Name: ANITA JAMES
Title or Position: CITY TREASURER
Credential:
Phone: 405-375-3705