Healthcare Provider Details

I. General information

NPI: 1871972430
Provider Name (Legal Business Name): CHEROKEE NATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395200 W 2900 RD
OCHELATA OK
74051-2463
US

IV. Provider business mailing address

PO BOX 1069
TAHLEQUAH OK
74465-1069
US

V. Phone/Fax

Practice location:
  • Phone: 918-535-6000
  • Fax: 918-535-2694
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: 918-535-6000