MEDICARE: BAPTIST HEALTHCARE OF OKLAHOMA

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	207P00000X	Emergency 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

General Provider Information

NPI Number	:	1316915564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST HEALTHCARE OF OKLAHOMA

Provider Business Mailing Address
First Line	:	1310 S MAIN ST
Second Line	:
City	:	GROVE
State	:	OK
Zip	:	74344-5304
Country	:	US
Telephone Number	:	918-786-2243
Fax Number	:	918-787-3643

Provider Business Practice Location Address
First Line	:	1310 S MAIN ST
Second Line	:
City	:	GROVE
State	:	OK
Zip	:	74344-5304
Country	:	US
Telephone Number	:	918-786-2243
Fax Number	:	918-787-3643

Authorized Official
Title or Position	:	CFO
Name	:	MR. DAVID H ZYCH
Credential	:
Telephone Number	:	918-786-2243

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	05/29/2008

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Directions to “BAPTIST HEALTHCARE OF OKLAHOMA ” Practice Location

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