Healthcare Provider Details

I. General information

NPI: 1780136705
Provider Name (Legal Business Name): CHOCTAW NATION HEALTH SERVICES AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 KERR AVE
POTEAU OK
74953-5270
US

IV. Provider business mailing address

1 CHOCTAW WAY
TALIHINA OK
74571-2022
US

V. Phone/Fax

Practice location:
  • Phone: 918-649-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT5210
License Number StateOK

VIII. Authorized Official

Name: JASON HILL
Title or Position: CHIEF MEDICAL OFFICER
Credential: DO
Phone: 918-567-7140