| Organization Name: | BRISTOW MEDICAL CENTER OPERATING COMPANY |
| NPI Number: | 1730414244 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STAN EARNHARDT (AUTHORIZED OFFCIAL) |
| Mailing Address: | 700 W 7th Ave Suite 6 Bristow |
| State: | OK US |
| Postal Code: | 740102302 |
| Phone Number: | 9183672215 |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2009 |
| NPI Last Update Date: | 01/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |