# STILLWATER MEDICAL CENTER AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stillwater Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407828908
- **Authorized official:** JERRY MOELLER (CEO)
- **Authorized official phone:** (405) 742-5701

## Contact information

- **Practice address:** 1323 W 6TH AVE, STILLWATER, OK 74074-4306
- **Practice address phone:** (405) 372-1480
- **Mailing address:** 1323 W 6TH AVE, STILLWATER, OK 74074-4306
- **Mailing address phone:** (405) 372-1480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 2272 | OK | Yes |

## Other

- **Enumeration date:** 02/07/2006
- **Last updated:** 08/22/2020