# STILLWATER MEDICAL CENTER AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blackwell Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558990192
- **Authorized official:** DENISE ADRIENNE WEBBER (CEO)
- **Authorized official phone:** (405) 742-5230

## Contact information

- **Practice address:** 706 S 13TH ST STE C, BLACKWELL, OK 74631-3705
- **Practice address phone:** (580) 363-9354
- **Mailing address:** PO BOX 720006, NORMAN, OK 73070-4006
- **Mailing address phone:** (405) 742-5300

## Taxonomy

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

## Other

- **Enumeration date:** 04/06/2020
- **Last updated:** 04/06/2020