Healthcare Provider Details

I. General information

NPI: 1891703716
Provider Name (Legal Business Name): CHEROKEE NATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 LENAPE DR
NOWATA OK
74048-4403
US

IV. Provider business mailing address

PO BOX 1069
TAHLEQUAH OK
74465-1069
US

V. Phone/Fax

Practice location:
  • Phone: 918-273-0192
  • Fax: 918-273-0194
Mailing address:
  • Phone: 539-234-2694
  • Fax: 539-234-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN ROBERT JONES
Title or Position: EXECUTIVE DIRECTOR, HEALTH SERVICES
Credential: DDS
Phone: 918-273-0192