Provider Demographics
NPI:1609157064
Name:INTEGRIS RURAL HEALTH, INC
Entity Type:Organization
Organization Name:INTEGRIS RURAL HEALTH, INC
Other - Org Name:INTEGRIS FAMILY FIRST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP INTEGRIS RURAL PHYS PRACTIC 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:PO BOX 5038
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73702-5038
Mailing Address - Country:US
Mailing Address - Phone:580-548-1367
Mailing Address - Fax:580-548-1583
Practice Address - Street 1:915 E GARRIOTT RD
Practice Address - Street 2:SUITE K
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-6156
Practice Address - Country:US
Practice Address - Phone:580-242-4300
Practice Address - Fax:580-242-4306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty