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General NPI Number Information
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NPI Number | 1992663637
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Entity Type | Organization
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Legal Business Name | 1
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1212 S BELMONT AVE
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City | OKMULGEE
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State | OK
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Zip | 74447-6310
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Country | US
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Telephone | 918-758-2710
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Fax | 918-756-2710
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Provider Business Mailing Address
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Address Line | 1212 S BELMONT AVE
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City | OKMULGEE
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State | OK
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Zip | 74447-6310
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Country | US
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Telephone | 918-758-2710
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Fax | 918-756-2710
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Authorized Official
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Title or Position | PATIENT ACCESS: RECEPTION/FRONT DES
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Name | LYNDOLA S DAWSON
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Credential |
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Telephone | 918-758-2710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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