ARBUCKLE MEMORIAL HOSPITAL (NPI# 1013215839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013215839 |
| Entity Type | Organization |
| Organization Name | ARBUCKLE MEMORIAL HOSPITAL |
| Other Organization Name | ARBUCKLE CLINIC AT DAVIS |
| Practice Address |
610 E Main St Davis OK 73030-1912 |
| Mailing Address |
2011 W Broadway Ave Sulphur OK 73086-4221 |
| Practice Telephone | 5803693500 |
| Practice Fax Number | 5803693513 |
| Mailing Telephone | 5803693500 |
| Mailing Fax Number | 5803693513 |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2011-03-09 |
| Authorized Official Name | BRUCE STEWART GILMORE (PHYSICIAN) |
| Authorized Official Telephone | 5803693500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
OK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100700790G | 05 |
| Other Name | Type Code |
|---|---|
| ARBUCKLE CLINIC AT DAVIS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700869492 | Arbuckle Memorial Hospital | General Acute Care Hospital | 2011 W Broadway Ave, Sulphur, OK 73086-4221 | 2005-11-28 |
| 1730541673 | Arbuckle Memorial Hospital | Clinic/Center | 2011 W Broadway Ave, Sulphur, OK 73086 | 2016-03-21 |
| 1194023911 | Arbuckle Memorial Hospital | Clinic/Center | 2007 W Broadway Ave, Sulphur, OK 73086-4221 | 2011-03-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ARBUCKLE MEMORIAL HOSPITAL | 2011 W Broadway Ave, Sulphur, OK 73086-4221 |
| Street Address |
610 E MAIN ST |
| City | DAVIS |
| State | OK |
| Zip Code | 73030-1912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790144160 | Our House Mhsa Inc | Community/Behavioral Health | 115 East Main, Davis, OK 73030 | 2016-02-15 |
| 1255677381 | Davis Public Schools | Local Education Agency (LEA) | 400 East Atlantic St, Davis, OK 73030 | 2012-12-18 |
| 1639462617 | Kathryn Howe | Clinic/Center | 112 East Main Suite 101, Davis, OK 73030 | 2011-05-24 |
| 1568730125 | Natalie K O'dell | Case Manager/Care Coordinator | 121 E Main St, Suite 101, Davis, OK 73030 | 2011-12-09 |
| 1629680038 | Stefanie Jane Fisher | Nurse Practitioner | 404 W Main St, Davis, OK 73030-1701 | 2020-08-18 |
| 1811506389 | Lee Sykes | Nurse Practitioner | 404 W Main St, Davis, OK 73030-1701 | 2020-07-30 |
| 1801095377 | Phillip Carl Tabor Jr. | Optometrist | 119w Main St, Davis, OK 73030-1747 | 2007-07-16 |
| 1306467618 | Tabor Eye Clinic, LLC | Optometrist | 119 W Main St, Davis, OK 73030-1747 | 2020-04-28 |
| 1225643844 | Kaitlin A Hesse | Physical Therapist | 201 W Main St, Davis, OK 73030-1749 | 2020-09-10 |
| 1730606062 | Amanda Felder | Physical Therapist | 201 W Main St, Davis, OK 73030-1749 | 2017-08-28 |
| Find all providers in zip 73030 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1255699112 | Meghan E. Scears, Md, Pllc | Clinic/Center | 808 24th Ave Nw Ste 202, Norman, OK 73069-6204 | 2012-04-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.