Healthcare Provider Details

I. General information

NPI: 1194878835
Provider Name (Legal Business Name): CREEK NATION HOSPITAL AND CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E COPLIN ST
OKEMAH OK
74859-4642
US

IV. Provider business mailing address

DEPT 1038
TULSA OK
74182-0001
US

V. Phone/Fax

Practice location:
  • Phone: 918-623-1424
  • Fax: 918-623-3015
Mailing address:
  • Phone: 918-756-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberEMS219
License Number StateOK

VIII. Authorized Official

Name: SHAWN TERRY
Title or Position: SECRETARY OF HEALTH
Credential:
Phone: 918-756-3334