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General NPI Number Information
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NPI Number | 1770497125
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Entity Type | Organization
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Legal Business Name | SOUTHERN PLAINS MEDICAL CENTER INC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 1631 ARLINGTON ST
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City | ADA
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State | OK
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Zip | 74820-2639
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Country | US
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Telephone | 405-224-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 W IOWA AVE
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City | CHICKASHA
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State | OK
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Zip | 73018-2738
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Country | US
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Telephone | 405-224-8111
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Fax | 405-594-0708
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Authorized Official
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Title or Position | OWNER
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Name | HARESHKUMAR BOGHARA
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Credential |
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Telephone | 469-985-3746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NULL
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