Organization
CHICKASAW NATION DIVISION OF HEALTH
Active
Other names
Chickasaw Nation Tishomingo Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE CARPENTER (CONTRACT MANAGEMENT COORDINATOR)
(580) 421-4570
Entity
Organization
Contact information
Practice address
817 E 6TH ST, TISHOMINGO, OK 73460-1800
(580) 371-2392
Mailing address
1925 WARRIOR WAY, ADA, OK 74820
(580) 421-4570
(580) 421-6283
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
07/10/2025
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