# TRIAD HEALTH SYSTEMS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TRIAD COMPLETE HEALTHCARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245867258
- **Authorized official:** AMY BEVERLEY (BILLING MANAGER)
- **Authorized official phone:** (580) 765-9451

## Contact information

- **Practice address:** 2703 N 14TH ST, PONCA CITY, OK 74601
- **Practice address phone:** (580) 765-9451
- **Mailing address:** 2703 N 14TH ST, PONCA CITY, OK 74601
- **Mailing address phone:** (580) 765-9451

## Taxonomy

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

## Other

- **Enumeration date:** 03/27/2020
- **Last updated:** 06/08/2020