Organization
PUSHMATAHA FAMILY MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA RENEE BATTON RN (CEO)
(918) 917-9999
Entity
Organization
Contact information
Practice address
109 STANLEY ROAD, CLAYTON, OK 74536
(918) 569-4143
(918) 569-7343
Mailing address
PO BOX 219, CLAYTON, OK 74536-0219
(918) 917-9999
(918) 569-7343
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
OK
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200072150B
—
OK
01
—
37D0669928
CLIA
OK
01
—
622460
UNIVERSAL DATA SYSTEM
OK
Enumeration date
10/05/2006
Last updated
11/17/2025
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