NPIMap

Organization Active NPI

Arbuckle Memorial Hospital

Doing business as Arbuckle Clinic at Davis

  • Medical Specialty Clinic/Center
  • Davis, OK
National Provider Identifier
1013215839
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
ARBUCKLE MEMORIAL HOSPITAL
Doing business as
Arbuckle Clinic at Davis
Practice address
610 E Main St
Davis, OK 73030-1912
Phone
(580) 369-3500
Fax
(580) 369-3513
NPI assigned
Mar 2, 2011
Last updated
Mar 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bruce Stewart Gilmore, MD
Title
Physician
Phone
(580) 369-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X OK Primary

Addresses

Primary practice location

610 E Main St
Davis, OK 73030-1912

Mailing address

2011 W Broadway Ave
Sulphur, OK 73086-4221
Phone (580) 369-3500

Other identifiers 1

IdentifierTypeStateIssuer
100700790GMedicaidOK

Other names 1

  • ARBUCKLE CLINIC AT DAVIS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arbuckle Memorial Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1013215839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 W BROADWAY AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864221",
            "telephone_number": "580-369-3500",
            "fax_number": "580-369-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E MAIN ST",
            "city": "DAVIS",
            "state": "OK",
            "postal_code": "730301912",
            "telephone_number": "580-369-3500",
            "fax_number": "580-369-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBUCKLE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "580-369-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700790G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARBUCKLE CLINIC AT DAVIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davis, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.