# NORTHEASTERN HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eastside Medical Clinic, Urgent Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366983850
- **Authorized official:** JACKIE HULLINGER (VP OF REVENUE CYCLE)
- **Authorized official phone:** (918) 458-2417

## Contact information

- **Practice address:** 22408 OK 51, TAHLEQUAH, OK 74464-4158
- **Practice address phone:** (918) 453-1234
- **Practice address fax:** (918) 453-2703
- **Mailing address:** 1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
- **Mailing address phone:** (918) 453-1234
- **Mailing address fax:** (918) 453-2703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/16/2017
- **Last updated:** 09/03/2026