Provider Demographics
NPI:1851648265
Name:INTEGRIS RURAL HEALTH, INC.
Entity Type:Organization
Organization Name:INTEGRIS RURAL HEALTH, INC.
Other - Org Name:ANKLE AND FOOT SURGERY OF ENID
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
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 960449
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0449
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 I
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-6154
Practice Address - Country:US
Practice Address - Phone:580-213-9755
Practice Address - Fax:580-234-3753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty