Provider Demographics
NPI:1952462558
Name:DUNCAN REGIONAL HOSPITAL,INC.
Entity Type:Organization
Organization Name:DUNCAN REGIONAL HOSPITAL,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:STREET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-251-8555
Mailing Address - Street 1:1407 N WHISENANT DR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1650
Mailing Address - Country:US
Mailing Address - Phone:580-252-5300
Mailing Address - Fax:580-251-8559
Practice Address - Street 1:1407 N WHISENANT DR
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1650
Practice Address - Country:US
Practice Address - Phone:580-252-5300
Practice Address - Fax:580-251-8559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUNCAN REGIONAL HOSPITAL,INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-13
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2235314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375083Medicare Oscar/Certification