Healthcare Provider Details

I. General information

NPI: 1366722183
Provider Name (Legal Business Name): INTEGRIS BAPTIST MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 N PORTLAND AVE
OKLAHOMA CITY OK
73112-6311
US

IV. Provider business mailing address

4120 N PORTLAND AVE
OKLAHOMA CITY OK
73112-6311
US

V. Phone/Fax

Practice location:
  • Phone: 405-945-4411
  • Fax:
Mailing address:
  • Phone: 405-945-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL L WEED
Title or Position: TREASURER
Credential:
Phone: 405-951-2737