Provider Demographics
NPI:1831103654
Name:INTEGRIS BAPTIST MEDICAL CENTER INC
Entity Type:Organization
Organization Name:INTEGRIS BAPTIST MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-951-2737
Mailing Address - Street 1:5400 N INDEPENDENCE AVE
Mailing Address - Street 2:100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5300
Mailing Address - Country:US
Mailing Address - Phone:405-949-3141
Mailing Address - Fax:
Practice Address - Street 1:3300 NW EXPRESSWAY ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4481
Practice Address - Country:US
Practice Address - Phone:405-949-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2297282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100806400EMedicaid
OK100806400CMedicaid
OK100806400BMedicaid
OK100806400BMedicaid
OK100806400EMedicaid