| Organization Name: | JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY |
| NPI Number: | 1235170754 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM G WILSON (PRESIDENT/CEO) |
| Mailing Address: | 1204 E Tamarack Rd Altus |
| State: | OK US |
| Postal Code: | 735211234 |
| Phone Number: | 5803796900 |
| Fax Number: | 5803796909 |
| NPI Enumeration Date: | 06/08/2006 |
| NPI Last Update Date: | 10/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 4040 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |