Provider Demographics
NPI:1538592332
Name:MCALESTER REGIONAL HEALTH CENTER MRHC CLINICS
Entity type:Organization
Organization Name:MCALESTER REGIONAL HEALTH CENTER MRHC CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHY PRAC COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-421-6987
Mailing Address - Street 1:1 E CLARK BASS BLVD
Mailing Address - Street 2:ATTN: TYRA ROLAN
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4209
Mailing Address - Country:US
Mailing Address - Phone:918-421-6987
Mailing Address - Fax:918-421-6998
Practice Address - Street 1:1 E CLARK BASS BLVD
Practice Address - Street 2:ATTN: TYRA ROLAN
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4209
Practice Address - Country:US
Practice Address - Phone:918-421-6987
Practice Address - Fax:918-421-6998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty