Provider Demographics
NPI:1225345788
Name:BAPTIST HEALTHCARE OF OKLAHOMA INC
Entity Type:Organization
Organization Name:BAPTIST HEALTHCARE OF OKLAHOMA INC
Other - Org Name:INTEGRIS SPECIALITY PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP INTEGRIS PHYSICIAN PRACTICE MGMT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-548-1367
Mailing Address - Street 1:DEPT 960413
Mailing Address - Street 2:
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0413
Mailing Address - Country:US
Mailing Address - Phone:580-548-1367
Mailing Address - Fax:580-548-1583
Practice Address - Street 1:4221 S WESTERN AVE
Practice Address - Street 2:SUITE 5045
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3450
Practice Address - Country:US
Practice Address - Phone:405-644-5185
Practice Address - Fax:405-644-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-05
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4819207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty