Healthcare Provider Details

I. General information

NPI: 1083401194
Provider Name (Legal Business Name): NEWMAN MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 15TH ST
WOODWARD OK
73801-3008
US

IV. Provider business mailing address

905 S MAIN ST
SHATTUCK OK
73858-9205
US

V. Phone/Fax

Practice location:
  • Phone: 805-713-1605
  • Fax: 580-938-2659
Mailing address:
  • Phone: 580-938-2551
  • Fax: 580-938-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CARLI WORD
Title or Position: MANAGER
Credential:
Phone: 580-938-5648