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General NPI Number Information
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NPI Number | 1154628113
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Entity Type | Individual
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Provider Name | BETH HITES DO
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Gender | Female
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Dates
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Enumeration Date | 02/27/2011
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 105 WALL ST
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City | POTEAU
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State | OK
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Zip | 74953-4433
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Country | US
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Telephone | 918-635-3591
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Fax |
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Provider Business Mailing Address
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Address Line | 503 WINCREST CIR
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City | POTEAU
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State | OK
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Zip | 74953-5491
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Country | US
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Telephone | 405-615-2070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 5229
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5229
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License Number State | OK
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