National Provider Identifier Database

CHOCTAW NATION OF OKLAHOMA
Primary Care


Contact Information

CHOCTAW NATION OF OKLAHOMA
205 E 3RD ST
BROKEN BOW, OK74728-4119
Phone: 918-567-7000
Fax: 918-567-7041
Website:
Specialty Taxonomy Code
* Primary Care 261QP2300X
Public Health, Federal 261QP0904X

* Indicates primary specialty

NPI Profile & details for CHOCTAW NATION OF OKLAHOMA

NPI Number 1770559619
Legal business name
LBN
CHOCTAW NATION OF OKLAHOMA
Authorized official TERESA JACKSON - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 02/28/2006
Last updated 01/17/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers
  • OK Medicaid: 100699600I

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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