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Organization

JEFFERSON COUNTY HEALTHCARE AUTHORITY

Active
Other names
Jefferson County Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD L GILLESPIE FACHE (CEO)
(580) 228-2344
Entity
Organization

Contact information

Practice address
U.S. HIGHWAYS 70 & 81, WAURIKA, OK 73573-0090
(580) 228-2344
(580) 228-3410
Mailing address
PO BOX 90, WAURIKA, OK 73573-0090
(580) 228-2344
(580) 228-3410

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2233
OK
282NC0060X
Critical Access Hospital
Primary
2233
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100730660F
OK
Enumeration date
07/13/2006
Last updated
06/14/2017
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