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Organization
INTEGRIS RURAL HEALTH INC
Active
Organization
INTEGRIS RURAL HEALTH INC
Active
Other names
David W Vanhooser MD Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY M BROWN (VP REGIONAL PHYSICIAN PRACTICE MGMT)
(580) 548-1367
Entity
Organization
Contact information
Practice address
707 S MONROE ST, ENID, OK 73701-7286
(580) 616-7634
(580) 237-7516
Mailing address
PO BOX 960097, OKLAHOMA CITY, OK 73196-0097
(580) 548-1367
(580) 548-1583
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200058050A
—
OK
01
—
200069200M
OK MEDICAID OSUFFS
OK
05
—
200308850B
—
KS
Enumeration date
12/16/2005
Last updated
02/25/2011
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