# TONKAWA HEALTHCARE SYSTEMS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TONKAWA MEDICAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942333737
- **Authorized official:** WILLIE JESSE STREET PA (PRESIDENT)
- **Authorized official phone:** (580) 628-4800

## Contact information

- **Practice address:** 600 E GRAND AVE, TONKAWA, OK 74653-3545
- **Practice address phone:** (580) 628-4800
- **Practice address fax:** (580) 628-3655
- **Mailing address:** PO BOX 532, TONKAWA, OK 74653-0532
- **Mailing address phone:** (580) 628-4800
- **Mailing address fax:** (580) 628-3655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 631 | OK | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 08/22/2020