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General NPI Number Information
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NPI Number | 1215043112
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Entity Type | Organization
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Legal Business Name | INTEGRIS MIAMI HOSPITAL
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 200 2ND AVE SW
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City | MIAMI
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State | OK
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Zip | 74354-6830
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Country | US
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Telephone | 918-542-6611
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 960400
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City | OKLAHOMA CITY
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State | OK
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Zip | 73196-0400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | C BRUCE LAWRENCE
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Credential |
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Telephone | 405-949-6066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 2193
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License Number State | OK
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