Organization
NORTHEASTERN HEALTH SYSTEM
Active
Other names
Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE HULLINGER (VP OF REVENUE CYCLE)
(918) 458-2417
Entity
Organization
Contact information
Practice address
1203 E ROSS BYP STE A, TAHLEQUAH, OK 74464-4158
(918) 453-1234
(918) 453-2703
Mailing address
PO BOX 500, TAHLEQUAH, OK 74465-0500
(918) 453-1234
(918) 453-2703
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/16/2017
Last updated
11/24/2025
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