# SEQUOYAH COUNTY CITY OF SALLISAW HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SEQUOYAH COUNTY CITY OF SALLISAW HOSPITAL AUTHORITY
- **Other names:** SMH Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780709550
- **Legal business name:** SEQUOYAH COUNTY CITY OF SALLISAW HOSPITAL AUTHORITY
- **Authorized official:** MR. CHARLES E. WADE (CEO)
- **Authorized official phone:** (918) 774-1100

## Contact information

- **Practice address:** 1109 E CHEROKEE AVE, SALLISAW, OK 74955-5035
- **Practice address phone:** (918) 774-1100
- **Practice address fax:** (918) 774-1103
- **Mailing address:** PO BOX 505, SALLISAW, OK 74955-0505
- **Mailing address phone:** (918) 774-1100
- **Mailing address fax:** (918) 774-1103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 2189 | OK | Yes |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 06/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200091560M | — | OK |