Organization
RENAL AND HYPERTENSION INSTITUTE OF NORTHEAST OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN WOODLIFF (BOARD OF MANAGERS)
(918) 453-2263
Entity
Organization
Contact information
Practice address
1607 S MUSKOGEE AVE, SUITE A, TAHLEQUAH, OK 74464-5440
(918) 453-2121
Mailing address
PO BOX 1008, TAHLEQUAH, OK 74465-1008
(918) 453-2121
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/20/2008
Last updated
09/10/2008
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