Organization
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Active
Parent organization
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Other names
INTEGRIS HEALTH MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTEGRIS HEALTH PONCA CITY HOSPITAL INC
Authorized official
DONNA WALLACE (ASSISTANT TREASURER)
(636) 359-4890
Entity
Organization
Contact information
Practice address
1908 N 14TH ST, STE 202, 203 & 207, PONCA CITY, OK 74601-2039
(580) 718-4501
Mailing address
3001 QUAIL SPRINGS PKWY FL 3, OKLAHOMA CITY, OK 73134-2640
(405) 252-8400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207VG0400X
Gynecology Physician
—
—
207VX0000X
Obstetrics Physician
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/26/2023
Last updated
10/24/2024
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