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Organization
NORTHEASTERN HEALTH SYSTEM
Active
Organization
NORTHEASTERN HEALTH SYSTEM
Active
Other names
Eastside Medical Clinic, Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE HULLINGER (VP OF REVENUE CYCLE)
(918) 458-2417
Entity
Organization
Contact information
Practice address
22408 OK 51, TAHLEQUAH, OK 74464-4158
(918) 453-1234
(918) 453-2703
Mailing address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 453-1234
(918) 453-2703
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/16/2017
Last updated
09/03/2026
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