Healthcare Provider Details

I. General information

NPI: 1083757926
Provider Name (Legal Business Name): MUSKOGEE REGIONAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 12/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ROCKEFELLER DR
MUSKOGEE OK
74401-5075
US

IV. Provider business mailing address

501 CORPORATE CENTRE DR SUITE 200
FRANKLIN TN
37067-2659
US

V. Phone/Fax

Practice location:
  • Phone: 918-682-5501
  • Fax: 918-684-2552
Mailing address:
  • Phone: 615-776-4300
  • Fax: 615-764-3030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number2177
License Number StateOK

VIII. Authorized Official

Name: DANIEL S. SLIPKOVICH
Title or Position: CEO
Credential:
Phone: 615-764-3000