Organization
FREEMAN-OAK HILL HEALTH SYSTEM
Active
Other names
Freeman Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN P. GAUDETTE (VP)
(417) 347-6277
Entity
Organization
Contact information
Practice address
310 2ND AVE SW, MIAMI, OK 74354-6743
(918) 542-7159
(918) 542-6320
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(918) 542-7159
(918) 542-6320
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2673
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100221020B
—
OK
05
—
100229930B
—
KS
05
—
242091734
—
MO
01
—
CH3383
RR MEDICARE
—
Enumeration date
02/19/2007
Last updated
09/29/2021
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