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NPI Code Detail

MEDICARE: CLEVELAND AREA HOSPITAL AUTHORITY

MEDICARE: CLEVELAND AREA HOSPITAL AUTHORITY
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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1174774855
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEVELAND AREA HOSPITAL AUTHORITY
Provider Business Mailing Address
First Line : 1400 W PAWNEE ST
Second Line :
City : CLEVELAND
State : OK
Zip : 74020-3020
Country : US
Telephone Number : 918-358-3588
Fax Number :
Provider Business Practice Location Address
First Line : 1400 W PAWNEE ST
Second Line :
City : CLEVELAND
State : OK
Zip : 74020-3020
Country : US
Telephone Number : 918-358-3588
Fax Number :
Authorized Official
Title or Position : CLINIC MANAGER
Name : SABRINA ALDRIDGE
Credential :
Telephone Number : 918-358-3588
Provider Enumeration Date : 10/01/2008
Last Update Date : 09/27/2020

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Directions to “CLEVELAND AREA HOSPITAL AUTHORITY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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