Organization
BRISTOW ENDEAVOR HEALTHCARE, LLC
Active
Parent organization
BRISTOW ENDEAVOR HEALTHCARE, LLC
Other names
Prague Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRISTOW ENDEAVOR HEALTHCARE, LLC
Authorized official
MELINDA KAY WHITAKER (CREDENTIALING COORDINATOR)
(918) 701-2313
Entity
Organization
Contact information
Practice address
810 9TH ST, PRAGUE, OK 74864-4582
(405) 566-3411
(405) 566-3410
Mailing address
1809 E 13TH ST STE 300, TULSA, OK 74104-4431
(918) 701-2313
(539) 235-0028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/20/2019
Last updated
05/30/2023
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