Provider Demographics
NPI:1750680765
Name:US PUBLIC HEALTH SERVICE INDIAN HEALTH
Entity Type:Organization
Organization Name:US PUBLIC HEALTH SERVICE INDIAN HEALTH
Other - Org Name:CLINTON INDIAN HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-951-3774
Mailing Address - Street 1:RR 1 BOX 3060
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-9303
Mailing Address - Country:US
Mailing Address - Phone:580-331-3300
Mailing Address - Fax:580-331-3565
Practice Address - Street 1:RR 1 BOX 3060
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-9303
Practice Address - Country:US
Practice Address - Phone:580-331-3300
Practice Address - Fax:580-331-3565
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US PUBLIC HEALTH SERVICE INDIAN HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal