Provider Demographics
NPI:1790551380
Name:CREEK NATION HOSPITAL & CLINICS
Entity Type:Organization
Organization Name:CREEK NATION HOSPITAL & CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-756-4333
Mailing Address - Street 1:DEPT 1467
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74182-0001
Mailing Address - Country:US
Mailing Address - Phone:918-346-7833
Mailing Address - Fax:
Practice Address - Street 1:2900 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-4078
Practice Address - Country:US
Practice Address - Phone:918-346-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CREEK NATION HOSPITAL & CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center