| Stillwater Medical Center Authority | |
|
706 S 13th St Ste C Blackwell OK 74631-3705 | |
| (580) 363-9354 | |
| Not Available |
| Full Name | Stillwater Medical Center Authority |
|---|---|
| Speciality | Clinic/Center |
| Location | 706 S 13th St Ste C, Blackwell, Oklahoma |
| Authorized Official Name and Position | Denise Adrienne Webber (CEO) |
| Authorized Official Contact | 4057425230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stillwater Medical Center Authority Po Box 720006 Norman OK 73070-4006 Ph: (405) 742-5300 | Stillwater Medical Center Authority 706 S 13th St Ste C Blackwell OK 74631-3705 Ph: (580) 363-9354 |
| NPI Number | 1558990192 |
|---|---|
| Provider Enumeration Date | 04/06/2020 |
| Last Update Date | 04/06/2020 |
| Medicare PECOS PAC ID | 2365353794 |
|---|---|
| Medicare Enrollment ID | O20201210001849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558990192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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