Provider Demographics
NPI:1629337381
Name:INTEGRIS RURAL HEALTH INC.
Entity Type:Organization
Organization Name:INTEGRIS RURAL HEALTH INC.
Other - Org Name:AARON SIZELOVE, DO CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP INTEGRIS BASS BAPTIST HEALTH CTR
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-548-1367
Mailing Address - Street 1:PO BOX 960443
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0443
Mailing Address - Country:US
Mailing Address - Phone:580-548-1367
Mailing Address - Fax:580-548-1537
Practice Address - Street 1:915 E GARRIOTT RD
Practice Address - Street 2:SUITE B
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-6153
Practice Address - Country:US
Practice Address - Phone:580-213-9745
Practice Address - Fax:580-234-5749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-15
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200219500FMedicaid