Provider Demographics
NPI:1932260536
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:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-251-8552
Mailing Address - Street 1:2621 N WHISENANT DR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-0911
Mailing Address - Country:US
Mailing Address - Phone:580-252-5300
Mailing Address - Fax:580-251-8559
Practice Address - Street 1:2621 N WHISENANT DR
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-0911
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:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2235273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37T023Medicare Oscar/Certification