Organization
TAHLEQUAH MEDICAL GROUP LLC
Active
Parent organization
TAHLEQUAH HOSPITAL AUTHORITY
Organization subpart
Yes
Provider details
NPI number
Legal business name
TAHLEQUAH HOSPITAL AUTHORITY
Authorized official
JULIE WARD (CFO)
(918) 453-2120
Entity
Organization
Contact information
Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Mailing address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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