Healthcare Provider Details

I. General information

NPI: 1669151718
Provider Name (Legal Business Name): HILGER MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 07/17/2023
Certification Date: 07/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 LEAHY AVE
PAWHUSKA OK
74056-5241
US

IV. Provider business mailing address

539 LEAHY AVE
PAWHUSKA OK
74056-5241
US

V. Phone/Fax

Practice location:
  • Phone: 918-331-8187
  • Fax:
Mailing address:
  • Phone: 918-331-8187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RHONDA ROCHELLE HILGER
Title or Position: OWNER
Credential: APRN
Phone: 918-331-8187