=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659220820
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CREEK NATION HOSPITAL & CLINICS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2026
-----------------------------------------------------
Last Update Date | 01/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1313 E 20TH ST
-----------------------------------------------------
City | OKMULGEE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74447-6303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-591-5700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1313 E 20TH ST
-----------------------------------------------------
City | OKMULGEE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74447-6303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-591-5700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY OF HEALTH
-----------------------------------------------------
Name | SHAWN TERRY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 918-233-9550
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------