Healthcare Provider Details

I. General information

NPI: 1578026571
Provider Name (Legal Business Name): LEFLORE COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 05/14/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S EAST BLVD
POTEAU OK
74953
US

IV. Provider business mailing address

105 WALL ST
POTEAU OK
74953-4433
US

V. Phone/Fax

Practice location:
  • Phone: 918-635-3576
  • Fax: 918-635-3158
Mailing address:
  • Phone: 918-635-3566
  • Fax: 918-635-3568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY B GRIFFIS
Title or Position: CEO
Credential:
Phone: 918-635-3441