Provider Demographics
NPI:1679070577
Name:INTEGRIS BASS BAPTIST HEALTH CENTER
Entity Type:Organization
Organization Name:INTEGRIS BASS BAPTIST HEALTH CENTER
Other - Org Name:INTEGRIS BASS SPECIALTY-GASTROENTEROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & COO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-949-3402
Mailing Address - Street 1:PO BOX 269032
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-9032
Mailing Address - Country:US
Mailing Address - Phone:405-252-8400
Mailing Address - Fax:405-713-4322
Practice Address - Street 1:707 S MONROE ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-7286
Practice Address - Country:US
Practice Address - Phone:580-977-1960
Practice Address - Fax:580-977-1959
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRIS BASS BAPTIST HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty