Provider Demographics
NPI:1093914780
Name:DUNCAN REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:DUNCAN REGIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:MCCRACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-251-8460
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:RUSH SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:73082-0497
Mailing Address - Country:US
Mailing Address - Phone:580-467-3373
Mailing Address - Fax:
Practice Address - Street 1:2000 W ELK AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1642
Practice Address - Country:US
Practice Address - Phone:580-251-8460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3926283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital