Healthcare Provider Details
I. General information
NPI: 1992726822
Provider Name (Legal Business Name): CREEK NATION HOSPITAL & CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2006
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 E COPLIN ST
OKEMAH OK
74859-4642
US
IV. Provider business mailing address
DEPT 1467
TULSA OK
74182-0001
US
V. Phone/Fax
- Phone: 918-623-1424
- Fax: 918-623-2809
- Phone: 918-756-3334
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHAWN
TERRY
Title or Position: SECRETARY OF HEALTH
Credential:
Phone: 918-756-3334