Healthcare Provider Details

I. General information

NPI: 1790551380
Provider Name (Legal Business Name): CREEK NATION HOSPITAL & CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N MAIN ST
MUSKOGEE OK
74401-4078
US

IV. Provider business mailing address

DEPT 1467
TULSA OK
74182-0001
US

V. Phone/Fax

Practice location:
  • Phone: 918-346-7833
  • Fax:
Mailing address:
  • Phone: 918-346-7833
  • 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: TRACY RANDALL
Title or Position: BILLING
Credential:
Phone: 918-756-4333