MEDICARE: INTEGRIS RURAL HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134104128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRIS RURAL HEALTH INC

Provider Business Mailing Address
First Line	:	PO BOX 5038
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73702-5038
Country	:	US
Telephone Number	:	580-548-1367
Fax Number	:	580-548-1537

Provider Business Practice Location Address
First Line	:	221 S GRAND AVE
Second Line	:
City	:	CHEROKEE
State	:	OK
Zip	:	73728-2029
Country	:	US
Telephone Number	:	580-596-3516
Fax Number	:	580-596-2320

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	GREG A MEYERS
Credential	:
Telephone Number	:	580-977-1831

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	12/16/2013

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Directions to “INTEGRIS RURAL HEALTH INC ” Practice Location

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