TAHLEQUAH FAMILY MEDICINE CLINIC NPI 1144633041

NPI Information

NPI: 1144633041
Provider Name: TAHLEQUAH FAMILY MEDICINE CLINIC
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
Address: 204 WOODLAWN AVE
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 456-8000

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NPI Details

TAHLEQUAH FAMILY MEDICINE CLINIC is a primary care clinic center in Tahlequah, OK. TAHLEQUAH FAMILY MEDICINE CLINIC NPI is 1144633041. The provider is registered as an organization entity type.

The provider's business location address is:

204 WOODLAWN AVE
TAHLEQUAH, OK
ZIP 74464-318
Phone: (918) 456-8000

The provider's authorized official is Larry Dean Sumner .
The authorized official title is Physician and has the following contact phone number (918) 456-8000.

The enumeration date for this NPI number is 6/9/2014 and was last updated on 6/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	14708	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100124340B	OTHER	OKLAHOMA	SOONERCARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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