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NPI Code Detail

MEDICARE: CHICKASAW NATION DIVISION OF HEALTH

MEDICARE: CHICKASAW NATION DIVISION OF HEALTH
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
1261Q00000XClinic/Center
2261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1982764395
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHICKASAW NATION DIVISION OF HEALTH
Provider Business Mailing Address
First Line : 1921 STONECIPHER BLVD
Second Line :
City : ADA
State : OK
Zip : 74820
Country : US
Telephone Number : 580-421-4570
Fax Number :
Provider Business Practice Location Address
First Line : 1438 HARDCASTLE BLVD
Second Line :
City : PURCELL
State : OK
Zip : 73080-8233
Country : US
Telephone Number : 405-527-4700
Fax Number : 580-421-4552
Authorized Official
Title or Position : CONTRACT MANAGEMENT COORDINATOR
Name : DENISE CARPENTER
Credential :
Telephone Number : 580-421-4570
Provider Enumeration Date : 12/08/2006
Last Update Date : 07/10/2025

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Directions to “CHICKASAW NATION DIVISION OF HEALTH ” Practice Location

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