# SEQUOYAH COUNTY-CITY OF SALLISAW HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northeastern Health System Sequoyah
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043959141
- **Authorized official:** STEPHANIE SIX (DIRECTOR)
- **Authorized official phone:** (918) 774-1100

## Contact information

- **Practice address:** 511 E REDWOOD AVE, SALLISAW, OK 74955-3020
- **Practice address phone:** (918) 775-1619
- **Practice address fax:** (918) 775-1618
- **Mailing address:** 213 E REDWOOD AVE, SALLISAW, OK 74955-2811
- **Mailing address phone:** (191) 877-4111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2022
- **Last updated:** 04/20/2023