Organization Name: | GRADY MEMORIAL HOSPITAL |
NPI Number: | 1407252596 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WARREN SPELLMAN (CEO) |
Mailing Address: | 1002 E Central Blvd Anadarko |
State: | OK US |
Postal Code: | 730054405 |
Phone Number: | 4052472551 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2014 |
NPI Last Update Date: | 11/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 24762 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |