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General NPI Number Information
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NPI Number | 1366075616
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Entity Type | Organization
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Legal Business Name | STILLWATER MEDICAL CENTER AUTHORITY
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Dates
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Enumeration Date | 02/14/2020
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 505 E HIGHWAY 33
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City | PERKINS
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State | OK
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Zip | 74059-4520
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Country | US
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Telephone | 405-547-4162
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Fax | 405-547-4159
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Provider Business Mailing Address
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Address Line | PO BOX 720006
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City | NORMAN
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State | OK
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Zip | 73070-4006
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Country | US
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Telephone | 405-742-5300
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DENISE ADRIENNE WEBBER
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Credential |
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Telephone | 405-742-5230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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