Organization
JEFFERSON COUNTY HEALTHCARE AUTHORITY
Active
Other names
Ryan Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLIS JANE MCDOWELL (CHIEF EXECUTIVE OFFICER)
(580) 228-2344
Entity
Organization
Contact information
Practice address
1104 6TH STREET, RYAN, OK 73565-0157
(580) 757-2451
Mailing address
PO BOX 157, RYAN, OK 73565-0157
(580) 757-2451
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
2233
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100730660
—
OK
Enumeration date
07/12/2006
Last updated
12/17/2008
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