Organization
SAC & FOX NATION
Active
Other names
Black Hawk Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEDORA MCDOUGLE (HEALTH DIRECTOR)
(918) 968-9531
Entity
Organization
Contact information
Practice address
RR 2 BOX 247, STROUD, OK 74079-9652
(918) 968-9531
(918) 968-0113
Mailing address
5406 NBU, PRAGUE, OK 74864
(918) 968-9531
(918) 968-0113
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
R0069265
OK
Other
Enumeration date
05/17/2007
Last updated
08/22/2020
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