Organization
INTEGRIS RURAL HEALTH INC
Active
Other names
Integris Bass Psychiatric Services
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY M BROWN (VICE PRESIDENT)
(580) 548-1367
Entity
Organization
Contact information
Practice address
2216 S VAN BUREN ST, ENID, OK 73703-8217
(580) 234-2220
(580) 233-8922
Mailing address
PO BOX 5038, ENID, OK 73702-5038
(580) 548-1367
(580) 548-1537
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200065440A
—
OK
01
—
200069200Z
MEDICAID OSUFFS
OK
Enumeration date
01/09/2006
Last updated
01/23/2012
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