Provider Demographics
NPI:1619308863
Name:STIGLER HEALTH AND WELLNESS CENTER, INC SEQUOYAH COUNTY
Entity Type:Organization
Organization Name:STIGLER HEALTH AND WELLNESS CENTER, INC SEQUOYAH COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:N
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-790-3653
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-0179
Mailing Address - Country:US
Mailing Address - Phone:918-967-3333
Mailing Address - Fax:918-967-4582
Practice Address - Street 1:1630 S KERR BLVD
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-7240
Practice Address - Country:US
Practice Address - Phone:918-790-2653
Practice Address - Fax:918-790-2657
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STIGLER HEALTH AND WELLNESS CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)