Organization · Type 2 NPI

Great Salt Plains Health Center, Inc.

Federally Qualified Health Center (FQHC) · Medford, OK

NPI number 1699025973 Active

Practice location

619 Front Street
Medford, OK 73759-1209

Call (580) 395-3200 Map

Fax (580) 596-2805

Mailing address

405 S Oklahoma Ave
Cherokee, OK 73728-2545

Specialties and licenses

Taxonomy	Code	License
Adult Medicine Physician	207QA0505X	None listed
Gynecology Physician	207VG0400X	None listed
Pediatric Adolescent Medicine Physician	2080A0000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

NPI record

NPI: 1699025973
Entity type: Organization (Type 2)
Issued: Sep 14, 2012
Last updated: Sep 22, 2020
Status: Active
Subpart: Yes of Great Salt Plains Health Center

Other names

<unavail>
GSP Health Medford · doing business as
GSP Health Medford · doing business as

Authorized official

Tim Starkey
CEO
(580) 596-2800

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1699025973

Great Salt Plains Health Center, Inc.'s National Provider Identifier is 1699025973, issued on Sep 14, 2012. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Medford, OK. The record was last updated on Sep 22, 2020.