Organization
CHICKASAW NATION DIVISION OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA TEEL (BUSINESS OFFICE MANAGER)
(580) 421-4570
Entity
Organization
Contact information
Practice address
1921 STONECIPHER BLVD, ADA, OK 74820-3439
(580) 421-4570
(580) 421-6283
Mailing address
1921 STONECIPHER BLVD, ADA, OK 74820-3439
(580) 421-4570
(580) 421-6283
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100747670A
—
OK
Enumeration date
02/11/2008
Last updated
03/27/2012
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