Individual
JAKE HILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23899 STATE HIGHWAY 74, PURCELL, OK 73080-6964
(405) 253-3838
Mailing address
23899 STATE HIGHWAY 74, PURCELL, OK 73080-6964
(405) 253-3838
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
YUP833152728
BLUE CROSS BLUE SHIELD
OK
Enumeration date
01/20/2014
Last updated
01/20/2014
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