Healthcare Provider Details
I. General information
NPI: 1902534209
Provider Name (Legal Business Name): HASKELL REGIONAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/13/2022
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
810 HIGHWAY 2 N
WILBURTON OK
74578-3625
US
IV. Provider business mailing address
10996 FOUR SEASONS PL STE 100C
CROWN POINT IN
46307-7762
US
V. Phone/Fax
- Phone: 918-205-4972
- Fax: 918-465-4830
- Phone: 219-228-1021
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KIRNJOT
SINGH
Title or Position: PRESIDENT
Credential: MD
Phone: 219-228-4355