# INTEGRIS RURAL HEALTH INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Integris Canadian Valley Family Care Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962403030
- **Authorized official:** JEFFREY M BROWN (VP OF PHYSICIAN PRACTICE MANAGEMENT)
- **Authorized official phone:** (580) 548-1367

## Contact information

- **Practice address:** 1468 N MUSTANG RD, MUSTANG, OK 73064-0000
- **Practice address phone:** (405) 376-1800
- **Practice address fax:** (405) 376-1856
- **Mailing address:** PO BOX 960033, OKLAHOMA CITY, OK 73196-0033
- **Mailing address phone:** (580) 548-1367
- **Mailing address fax:** (580) 548-1583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 01/02/2012