MEDICARE: BASS MEMORIAL BAPTIST HOSPITAL

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

General Provider Information

NPI Number	:	1326040817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BASS MEMORIAL BAPTIST HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 960061
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73196-0001
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	:	PRESIDENT RURAL HEALTH
Name	:	OSCAR KALMANJE WEINMEISTER JR.
Credential	:
Telephone Number	:	405-951-2616

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	08/22/2020

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Directions to “BASS MEMORIAL BAPTIST HOSPITAL ” Practice Location

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