Healthcare Provider Details

I. General information

NPI: 1548247489
Provider Name (Legal Business Name): JANE PHILLIPS NOWATA HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 S. LOCUST
NOWATA OK
74048-0426
US

IV. Provider business mailing address

237 S LOCUST ST
NOWATA OK
74048-3660
US

V. Phone/Fax

Practice location:
  • Phone: 918-273-3102
  • Fax: 918-273-5490
Mailing address:
  • Phone: 918-273-3102
  • Fax: 918-273-5490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number2187
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number2187
License Number StateOK

VIII. Authorized Official

Name: JASON RUSSELL MCCAULEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 918-273-5413