Healthcare Provider Details

I. General information

NPI: 1659443372
Provider Name (Legal Business Name): INTEGRIS BAPTIST MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SPENCER RD
SPENCER OK
73084-3649
US

IV. Provider business mailing address

PO BOX 268907
OKLAHOMA CITY OK
73126-8907
US

V. Phone/Fax

Practice location:
  • Phone: 405-427-2441
  • Fax:
Mailing address:
  • Phone: 405-427-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number2297
License Number StateOK

VIII. Authorized Official

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