Basic Information
| Provider Information | |||||||||
| NPI: | 1124569744 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DUNCAN REGIONAL HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | D/B/A JEFFERSON COUNTY HOSPITAL D/B/A VELMA FAMILY CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 100 | ||||||||
| Address2: | |||||||||
| City: | DUNCAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 735340100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802518554 | ||||||||
| FaxNumber: | 5802518559 | ||||||||
| Practice Location | |||||||||
| Address1: | 404 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | VELMA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5804442630 | ||||||||
| FaxNumber: | 5804442628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2017 | ||||||||
| LastUpdateDate: | 03/15/2017 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | VOLINSKI | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT-FINANCE AND CFO | ||||||||
| AuthorizedOfficialTelephone: | 5802518554 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.