| Northeastern Health System | |
|
104 Lone Oak Cir Fort Gibson OK 74434-5001 | |
| (918) 478-2101 | |
| (918) 478-6008 |
| Full Name | Northeastern Health System |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 Lone Oak Cir, Fort Gibson, Oklahoma |
| Authorized Official Name and Position | Julie Ward (CFO) |
| Authorized Official Contact | 9184532120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeastern Health System Po Box 500 Tahlequah OK 74465-0500 Ph: (918) 478-2101 | Northeastern Health System 104 Lone Oak Cir Fort Gibson OK 74434-5001 Ph: (918) 478-2101 |
| NPI Number | 1013458652 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 05/18/2017 |
| Medicare PECOS PAC ID | 1456255025 |
|---|---|
| Medicare Enrollment ID | O20170605000888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013458652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Limitless Physical Therapy Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1207 S Lee St, Fort Gibson, OK 74434 Phone: 918-207-7298 |